ASCNE ROM FORM
General Instructions:
1. Please fill out the form completely
2. Send form to : Mary Ann Stoddart
52 Eastern Ave
South Deerfield, MA 01373
ascne@library.umass.edu
3. One form per dog or Junior per day.
Multiple class entries ( Conformation, Obedience, Herding) may be
included on the same form, but it can only apply to one exhibitor.
4. Must be received by the ROM co-ordinator no later than 30 days after
the show in which they were earned
5. PUPPY NAME CHANGES must be reported on a ROM form.
Part 1. GENERAL INFORMATION
Show Name:_________________________________________ Date:________________
Judge's Name:___________________________________________________
Owner's or Parent's Name:____________________________________________
Owner's or Parent's Address:__________________________________________
Junior's Name:_________________________________________ Age:_____________
Dog's Registered Name:_____________________________________ Sex________
Part 2. CONFORMATION
NON- REGULAR CONFORMATION - PUPPIES:
Class Entered: __________Class Placement: ___________ No In Class________
Show Award : ( BP or BOSP)_____________________
No. of P-Dogs:________ No.of P-Bitches:__________ Tot.No.ofPups:_____________
REGULAR CONFORMATION - DOGS/BITCHES
Class Entered: _____________________
Class Placement: ________________ No. of Dogs In Class: _______________
Show Award: (WD,WB,etc)_______________________
IF Taking a Show Award:
Tot. No. of Class Dogs:______________ Tot. No. of Class Bitches:__________
Tot. No. of Special Dogs:____________ Tot. No. of Special Bitches:________
Grand Total of Entries ________________________
Part 3. JUNIOR SHOW
Class Entered:_________________________________
Class Placement:______________________ No. of Jrs In Class:____________________
Show Award: ( BJH- Best Jr Handler)___________________
If taking a Show Award Total No. of Juniors:_____________________
Part 4. OBEDIENCE/ HERDING
Dog's Class___________________________ Score_______________
Show Secretary's Name ( Print):_____________________________________________
Show Secretary's Signature:_____________________________________________