Futurity Individual Nomination Original

Directions: First, read the TTCA Futurity Rules and TTCA Guidelines for Responsible Breeders if you have not done so already. After you have filled out the form all the way to the bottom, simply click on the “E-mail Form” button below to submit your form.

This nomination form may be submitted by either an Owner or a Breeder.
See Breeder requirements below for Non-TTCA Member-Breeder submissions*.

Fee: $50.00
Nomination information will not be shared except as necessary for clarification with the breeder, owner, TTCA
officials, and/or show superintendent. Confidentiality of nominations cannot be guaranteed.

To allow sufficient time for TTCA processing and nominator’s receipt of a Futurity Number prior to making an entry
in any Futurity Stakes event, nomination must be submitted no later than 2 weeks prior to the close of entries for
such event.

Dogs may be nominated individually if his/her litter would have qualified for nomination in all ways except being
past the 4 month litter nomination cut-off.

*The TTCA member-breeder of the dog being nominated must approve the individual dog nomination and
must have been in compliance with all Futurity rules from the time of breeding until present (see TTCA
Member-Breeder section below).

It is the nominator’s responsibility to provide complete and accurate information for eligibility.

Birthdate:

,
Registered Name, including current titles
AKC # Gender: Male Female
Dam Name
Dam AKC or Foreign Registration :
Sire(s) Name(s)
Sire(s) AKC or Foreign Registration #(s)

Nominator: (complete only if Nominator is not the TTCA Member-Breeder)
Nominator does not have to be a TTCA member.)
Name:
Address:
City: State (or Province) Abbreviation: Zip (Postal Code):
Phone Number: E-mail:
Confirm E-mail:

TTCA Member-Breeder(s):
If there is more than one breeder/owner of dam, list each in exact order as stated on AKC Registration or Lease;
the first listed TTCA member-breeder shall be the breeder of record for Futurity reward purposes, and all contact
information should be provided for this person..

Name:
Address:
City: State (or Province) Abbreviation: Zip (Postal Code):
Phone Number:
E-mail:
Confirm E-mail:

I have read and am in compliance with the TTCA Guidelines for Responsible Breeders.
I have read and accept the TTCA Futurity Stakes rules.

The Futurity Chair shall determine whether the information is sufficient for eligibility. It shall be the responsibility of the Nominator to provide any subsequently updated identification or ownership information to the Futurity Chair in a timely manner to maintain competition eligibility.

Futurity Stakes Judge Nomination (optional)
Please review the Futurity Stakes Rules, Judges nomination eligibility, prior to making a nomination.
A TTCA member-breeder may provide one judge nominee annually for the Futurity Stakes two years ahead with a nomination, regardless of the number of litters or individual dogs that are nominated. Please include your complete Judge nominee’s contact information below

Nominated Judge’s Name
Address:
City: State (or Province) Abbreviation: Zip (Postal Code):
Phone Number:
E-mail:
Confirm E-mail:

Futurity Stakes Trophy Fund Sponsorship (optional)

Amount $
Exact spelling of sponsorship information (name, kennel, in memory of, etc.)

Sponsorship donation will be applied to the next upcoming Futurity Stakes

Select one:	Add to the Futurity Stakes Fund
	Apply to the following specific category or class

Create the Nomination Form by completing the fields above. Be sure to check the boxes that indicate that you have read and accept the TTCA Futurity Rules and that you have read and are in compliance with the TTCA Guidelines for Responsible Breeders. Finally click the “E-mail Form” button below. This will send the completed form to Claire Coppola, Futurity Chair.

To complete your registration, write a check payable to TTCA, and mail it to the address below (no SASE is necessary) or pay online.

You will receive an email confirming receipt of your Nomination Form. After your payment is received, you will be emailed your Official Futurity Individual Number, which indicates the successful completion of your Futurity individual registration.

Payment can be made online or send entry fee to:
Claire Coppola
11583 E Daley Cir
Parker, CO 80134
TOTAL AMOUNT $ ($50 nomination fee + optional trophy sponsorship)

I am mailing a check payable to TTCA I am paying online