Application risk assessment

    Required fields*

    Owner female

    Name*

    Address*

    Postal code*

    City*

    Country*

    E-mail*

    Member VHNK*


    Female

    Pedigree name*

    Pedigree number*

    Date of birth*

    At least two, but preferably three males per female:

    Male 1

    Pedigree name*

    Pedigree number*

    Date of birth*

    Male 2

    Pedigree name*

    Pedigree number*

    Date of birth*

    Male 3

    Pedigree name:

    Pedigree number:

    Date of birth


    Payment

    Please transfer the amount due (VHNK members € 40- / non-members € 50,-) - at the same time as sending this form - to bank account number IBAN NL70 RABO 0328 3693 06 BIC: RABO NL2U, in the name of Vereniging Het Nederlandse Kooikerhondje. Stating: Risk assessment + owner name.

    As soon as the amount is in the above-mentioned account, the application will be processed.


    * I have taken note of and accepted the privacy statement and the collection and processing of my personal data, as described in the Privacy statement of the VHNK.

    Comments:

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