K-9 SERVICE DOG AWARD APPLICATION

2008

Please complete the following application

City:                        Dog's Name:  

Dog's Age:       Handler's Name:       Dog's Trainer: 

Type of Service(s):                      

Most notable accomplishment for the time period (1/2008-10/2008):

Accomplishments for 2008 (give brief details):              Total # of missions (2008): 

City's K-9 Division Information:

Number of K-9's:       Number GSD's:       Other Breeds: 

Total # of missions preformed per year: 

Additional statistics/information:

Contact Name:       Contact phone #:    Best time:    

Contact E-Mail

NOTE:  Please submit a picture(s) of your dog if possible.

(Please click submit upon completion to submit on-line)

or complete form, print and mail to:

Gerry Colligan

10156 Bolling Blvd.

Carrollton, Va. 23314

Call Gerry at (757)357-5031 or e-mail at gericoshep@yahoo.com,

if you need additional information.