Dog Auction Form

Vendor Details

Name *

First

Last

Stud Name

Contact Number *

Email Address *

Postal Address *

GST Registered *

Breeder Source Number *

Direct Deposit (for proceeds)

Account Name *

BSB *

Account Number *

Dog Details

Dog Name *

WKC Registered *

Microchip Number *

Date Implanted *

Gender *

Desexed *

Date of Birth *

Breed *

Colour *

Sire

Dam

Medical History

Last Vaccination Date *

Vaccination record available *

Last Worming Date *

Worming record available *

Last Flea/Tick Treatment *

Flea/Tick Treatment record available *

Dog Ability Level

Any other comments

Catalogue description (For AuctionsPlus and Physical Catalogue) *

Upload a photo (for use in catalogue)

Click or drag files to this area to upload. You can upload up to 2 files.

Select option to Upload sample video (for balloting)

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URL

Auction Entry Payment

Price: $ 100.00

Please enter Card Number and Name on Card for $100 Payment for Auction Entry. *

Card

Name on Card

Vendor Details

Direct Deposit (for proceeds)

Dog Details

Medical History

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