NDGAA ONLINE WORKSHOP & CERTIFICATION PRE-REGISTRATION FORM

*Please fill in the location that you are pre-registering for.

*Fill out the Form in full.
*Complete the payment section and hit the SUBMIT.
 
Name:  
Address:  
City, State,  Zip:  
Phone to Reach Me:  
Email:  
     
Salon Name:  
Salon Address  
Salon City, State,  Zip:  
Salon Phone:  
 
Pre-Registration - Full Workshop/Private Testing
     
Location:  
Event Date:  
     
Full Workshop – $125 Non-Member fee 
Full Workshop – $110 Member fee

Mini Workshop - $75 Non-Member fee
Mini Workshop - $65 NDGAA Member fee

  Non-Sporting $125
  Sporting $125
  Terrier $125 (2 Terriers + Written/Practical Test)

Members Only
Long Legged Terrier $75 Short Legged Terrier $75  Terrier Written/Practical Test $60
    
If choosing to groom 1 terrier, you must also take the terrier written exam.

  Master Exam $125
  NDGAA Breed Profile Study Kit – $35
 
 

Payment Information  
  Name on Credit Card
  Card Type
  Card Number
  Expiration Date
  Card Billing Address
  City/State/Zip


 

 

 


 

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Agreement
: Unless you have checked the two boxes below in agreement with the terms and conditions for pre-registration you will not be pre-registered for the events you have selected

By Checking this box I agree and authorize my credit card to be charged for the activities and events I have checked to sign up for.  

Yes/No     By a YES in this box, I Hereby Agree To Authorize NDGAA to charge my credit card for check activities & events in the amount listed below: 

(Please Enter the total dollar amount for the activities you are pre-registering for)
TOTAL $  


  Yes/No    By typing a YES in this box, I/We hereby agree that neither NDGAA, nor the event host hotel or business, their sponsors, agents, employees, or representatives shall be liable for any loss, damage, harm or injury to the property or person of the applicant or its representative resulting from fire, accident, theft or other causes.  Attend at your own risk - I/We hereby agree that I/We have read and understand this policy, and I/We Hereby Acknowledge that having read and understand the limits of liability for this event I/We agree to the risk liability.

Click the Submit Tab to complete pre-registration for the events you have selected

 

NDGAA
P.O. Box 101,   Clark, PA 16113
Ph. 
(724) 962-2711 - Fax  (724) 962-1919