ESAA HEALTH
& GENETICS COMMITTEE
APPLICATION FOR BAER DATABASE
INSTRUCTIONS: (check one)
___SINGLE DOGS: Submit this Application, ESAA
BAER Test Form*, copy of BAER tracing and non-refundable fee of
$5.00 payable to ESAA (U.S.
Funds). Fill in lines 1-4 & 6-10.
___SINGLE DOGS PREVIOUSLY SUBMITTED ON LITTER TEST FORM:
Submit this Application. No fee. Fill in
lines 1-10.
___LITTERS: Submit this Application, ESAA BAER
Test Form* and copies of BAER tracings. No fee. Fill
in lines 1, 4, & 6-10.
Mail To:
Jane Wooding
ESAA BAER Data Base
2 Hemlock Trail
Redding, CT 06896
203-938-1199
Email: Hnjwooding@aol.com
- BAER Test performed
by_________________________________Date of Test_______
- Name of Dog ________________________________________Sex
___ Color_______
- AKC/CKC Registration # ______________________________
- Date of Birth_______________________
- For puppies on previously submitted Litter Test Form:
"Dog #" on litter Test Form_______
Name/Identification on
Litter Test Form_____________________________________
- Sire
____________________________________________ Reg #
________________
- Dam ____________________________________________ Reg #
_______________
- Owner(s)
_____________________________________________________________
- Address
______________________________________________________________
_______________________________________________________________
- Phone _______________________
I authorize the tester to release any information required by
the Health & Genetics Committee of the English Setter
Association of America for the sole purpose of verifying the BAER
test listed above.
Owner(s) Signature __________________________________________
Date ____________
*Equivalent of signed and dated statement from
tester may be submitted.
Send mail to dnjmates@ air-speed.net with questions or
comments about this web site.
Copyright © 1997-2007 English Setter
Association Of America. All Rights Reserved. Forms may be printed
or downloaded for personal use only.
Last modified: March 09, 2008