4-H 390
DOG RECORD
Dr. Norman D. Long, Extension Specialist - 4-H & Youth
and State 4-H Dog Advisory Committee
Record for Year________
Member’s Name------------------------------------------------------------- Date of Birth_______________________
Month Day Year
Complete Mailing Address---------------------------------------------------------------------------------------
R.R., Box, Street	City	State	Zip
County __-----------------------Township------------------------ Telephone____________________Yr. in 4-H_______
You show in	(including this yr.)
Level of obedience training attempted (check one):
First Year—Section A
First Year—Section B
Second Year
Third Year—Section A
Third Year—Section B
Fourth Year—Section A
Fourth Year—Section B
Fifth Year-Section A
Fifth Year—Section B
Sixth Year—Section A
Sixth Year—Section B
Auxiliary Activities
(check all that apply)
Costume Class—Junior (10-13)
Costume Class—Senior (14-19)
County Drill Team
Other (List)
Information about Your Dog
Previous training of dog (level and location)____________________
Dog’s Name____________________________ Date of Birth_____________________ Breed (s) -------------------------
Sex___________Rabies Shot_____________ Distemper_____________Hepatitis----------- Leptospirosis--------------
Date	Date	Date	Date
Date project was started___________________ ,19_______ Date project was completed ------------------ ,19-----
Summary of Expenses and Time
Feed Cost
Health Care & Veterinary Expenses
Equipment & Supplies
Miscellaneous Expenses
TOTAL
Total hours spent in training, grooming and exercising
I have reviewed this record and believe it to be correct.
Signature of Leader____________________________________________________ Date----------------------- (Beginning)
Signature of Leader____________________________________________________ Date--------------------------- (Midway)
Signature of Leader_________________________________________________— Date ------------------------ (Conclusion)