LRCA - 2024 Title Rosette Application

Applications & Payment (if applicable) must be received no later than 2/1/2025

Eligibility:  LRCA Member in good standing --- Lagotto Romagnolo dogs only

AKC Recognized titles & Nose Work titles from other organizations

Sign in to Google to save your progress. Learn more
Email *
LRCA Member Information
Member Name (First Last) *
Mailing Address (please include street, city, zip) *
Email Address *
Contact Phone #: *
Membership Status 
(Cost:  Regular/Voting Members - Complimentary, Associate Member - $15 per title rosette)
 *
Dog's Information:
Please complete one form for each dog that has earned titles
Dog's Registered Name as you'd like it printed on the ribbon 

(You may include non-AKC recognized titles for the name – ex: GCH Curly Sue RL1, MACH, NW1, SBN, RATN, FDCH, CGC)
 *
Titles Earned in 2024 (AKC Titles or Nose Work Titles from other organizations)

Please include the Title Abbreviation, Title Name and Date Earned. 

List each title on a new line.

example: TKN - Trick Dog Novice - 5/2/2024
 *
IMPORTANT
Applications & Payment (if applicable) must be received no later than 2/1/205

Email Awards@lagottous.com with any questions

For Associate Members Payment- -PayPal link or to pay via check
Regular/Voting Members - Complimentary, Associate Member - $15 per title rosette

(you may need to log into your LRCA account to pay)

A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms