Patch Program Request
Instructions: Please include as much information as possible to help us tailor the Patch Program to your event. Once this form is completed, we will direct you to order the patches for your event, the cost of each Patch is $1. Then, we will create the Patch program document and send you a digital copy you can print at your convenience.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address- Please tell us the address where you would like the Patches delivered.
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Club Name
*
Event Name
*
Date
-
Month
-
Day
Year
Date
Are you hosting the Patch Program through the AKC Booth?
*
Yes
No
How many children are you expecting to participate in this program (estimated)?
*
Select the age range(s) of Patch Program participants:
Kindergarten - 3rd Grade
4th grade & Up
Please select ALL of the following that you will feature at your show.
*
AKC Rally
AKC Scent Work
Agility
Beginner Puppy
Canine Good Citizen
Conformation
Dock Diving
Earthdog
Fast CAT
Field Events
Grooming Tables
Herding
Junior Showmanship
Lure Coursing
Meet the Breeds
Obedience
Tracking
Trick Dog
Barn Hunt
Other
Please list any questions you would like us to answer.
Submit
Should be Empty: