German Shepherd Dog Federation of South Africa

  PO Box 50222  Hercules 0030
Tel   (012) 376-2583
     Fax  (012) 376-2459
E-mail: info@gsdfederation.co.za

 Application for registration of a Kennel Name (AFFIX)

 Please complete in block letters and forward to the Secretary of the Federation

 Name of Applicant (s): __________________________________________________________

Postal Address: _________________________________________________________________ 

______________________________________________________ Code: ___________________

I/We, the undersigned, hereby declare that I am/we are *member (s)/have applied for membership of the Federation. I/We request that one of the names, which are listed below in order of preference, be registered as a Kennel Name (Affix) for my/our exclusive use and declare that, to the best of my/our knowledge, none of the names below are in use, have been used or can be confused with another name, trademark or Kennel Name of any other party. 

Please list three names of maximum length 16 letters in order of preference. Include the connector you want used (e.g. of, van, vom etc.): 

1.                ________________________________________________________________________

 2.                _______________________________________________________________________

 3.                ______________________________________________________________________ 

Signature(s) of Applicant(s):  __________________________________________________

Date: _________________20______ GSDF Membership No(s):   _____________________

* Delete what is not applicable

The GSD Federation is proudly sponsored by Nola

Form B1/04