ASOCIAŢIA CHINOLOGICĂ ROMÂNĂ

(membre de la Federation Cynologique Internationale)

Secretariat: Bd. Dinicu Golescu nr. 37/C/70, Bucureşti 010867
Corespondenţă: C.P. 262 - O.P. 12, Bucureşti 014750
Tel: +40 21 3143763. / Fax: +40 21 3161321
E-mail: office@ach.ro / Web: www.ach.ro

BULETIN DE INSCRIERE Vă rugăm să completaţi cu litere de

tipar sau maşina de scris!
BULLETIN D’INSCRIPTION Please write in capitals!
Nur Schreibmaschinen oder
MELDESCHEIN Blockshrift!

Expo: ______________________________________________________________
Clasa:
Class:
Klasse: ___________________________________________________________________________________
Rasa: Sex:
Breed: Sexe:
Rasse: __________________________________________ Geschlecht: ______________________________
Numele câinelui:
Dog’s name:
Name des Hundes: _________________________________________________________________________
Cartea de origine: Nr.:
Studbook abreviation: No.:
Abkürzung des Stammbuches: _____________________ Nr.: _____________________________________
Născut la data:
Date of birth:
Wurfdatum: _______________________________________________________________________________
Culoare şi semne distinctive:
Colour:
Farbe und Abzeichen: ______________________________________________________________________
Păr/lung, scurt, aspru/:
Hair /long-, short, wire/
Haarart /lang-, kurz-, rauh-/: _________________________________________________________________
Numele tatălui:
Sire:
Vater des gemeldeten Hundes: ______________________________________________________________
Numele mamei:
Dam:
Mutter des gemelden Hundes: _______________________________________________________________
Crescător:
Breeder:
Züchter: __________________________________________________________________________________
Proprietar:
Owner:
Eigentümer: _______________________________________________________________________________
Domiciliu:
Domicile:
Wohnort: __________________________________________________________________________________

Tel-Fax:
Phone-Fax: _______________________________________________________________________________

E-mail: __________________________________________________________________________________
Vă rugăm să anexaţi copia certificatului de origine al câinelui înscris.Please enclosed the pedigree’s copy.
Fiecare câine încris este acceptat în expoziţie numai pe baza carnetului de sănătate cu vaccinările la zi (vaccinarea antirabică
obligatorie)! Each dog participating must be effectively vaccinated against rabies (Please bring the vaccination certificate!).

__________________________________________ Loc / Place; Data / Date; Semnătura/Signature