ROMC ROMCP Application – CSSA – Canadian Shetland Sheepdog Association

Dog Information

Dog's Registered Name (with all titles)

CKC Registration Number

Sex Male Female

Birth Date Approximate date acceptable.

Color

Sire (with titles)

Dam (with titles)

Breeder & Owner Information

Breeder(s) Full Name

Owner(s) Full Name

Mailing Address

City

Province / Territory

Postal Code

Phone

Email Address

Champion Offspring

Eligibility: List all champion offspring who hold a Canadian Championship (Can CH) or higher, or an American Championship recognized under CKC rules.

ROMC requires 5 or more champion offspring. ROMC-P requires 5 or more who are themselves producers. Eligibility is verified by the ROMC Chair — not enforced by this form.

1 offspring entered

Offspring #1

Registered Name (with titles)

Sex

Title(s) Earned

Country

Notes (optional)

Application Type ROMC ROMC-P

ROMC-P requires that 5 or more of the listed offspring are themselves producers.

Photo & Declaration

Photo (optional) Accepted formats: JPG, PNG. Maximum file size: 5 MB.

Additional notes or information (optional)

Declaration

I consent to the collection of this personal information under the Privacy Act for the purposes of administering the CSSA Award programs.

I declare that the information provided in this application is accurate and complete to the best of my knowledge.

Electronic Signature (type your full name)

Date June 21, 2026

National Parent Club of the Shetland Sheepdog in Canada

ROMC & ROMC-P Application

Application received!

Dog Information

Breeder & Owner Information

Champion Offspring

Photo & Declaration

Declaration