The Dalmatian Club of America
Versatility Certificate Application 
Versatility Certificates are available to Dalmatian Club of America members, in good standings, whose dog has met the criteria listed below. The certificates will be awarded each year at the National Specialty.

DIRECTIONS: Complete all if the information required and return application with the necessary documentation to the address below. A copy of the certificate of completion or an AKC performance history printout must verify all titles.

Registered name of dog: ___________________________________________________

AKC number: _____________    Date of birth: _____________

Owner(s) of dog: ___________________________________________________

Certificate being applied for is (Check One): 

Performance Ability Certificate (PAC); _____
Requires three performance titles 
Conformation Performance Certificate (CPC); _____
Requires CH and two performance titles

List the date titles were earned in related discipline:

Conformation (CH) ____________________________
Obedience (CDX) _____________________________
Road Trial (RD or RDX) _______________________
Tracking (TD) ________________________________
Agility (OA or OJWW) _________________________

Return application and documentation to
Lynn Luikart
10130 Atchison Rd.
Centerville, OH   45458
koiradals@att.net