CROATIAN KENNEL CLUB Ilica 61, 10000 Zagreb

T: +385(0)1 4846 124; +385(0)1 4846 126 F: +385(0)1 4815 356 E: W: www.hks.hr

APPLICATION

Croatian Show Champion (CH HR I)

DOG INFORMATION
Breed
Dog name
Pedigree number / Date of birth
OWNER INFORMATION
Surname and name
Address
Postal code / City
Country
E-mail
Dog show / Date of the show / Title on show / Judge
1.
2.
3.
4.
Fee for the creation of certificate is 20,00 Euro
+ Fee for the ornament diploma is 20,00 Euro
Payment can be done to bank account or with credit card.
Do you want the ornament diploma to be made: / YES / NO
PAYMENT TO BANK ACCOUNT / PAYMENT WITH CREDIT CARD ( additional amount of 5% will be charged to cover the costs of card payment)
Croatian Kennel Club, Ilica 61, 10000 Zagreb
Zagrebačka banka d.d
2360000-1000000013
Kto.No 2400026293 – 3206548
SWIFT ZABA HR2X
IBAN code HR5723600001101353640 / Type: VISA DINERS MASTER CARD
Card no.______
CVV/CVC code _____ Expiry date ______
Total amount ______Euro
Credit card holder:______
Place and date: / Signature: