Fill in the Blanks

A Project of the English Shepherd Club Registry

The English Shepherd Club Registry database (ESCRdB) is one of the most
comprehensive tools for recording and promulgating information about a breed of
domestic animal ever developed.

There is no other dog registry like it. It is a powerful resource for preserving the history
of our breed and conserving the English shepherd as a healthy, sound companion and
working partner for the future. Other registries offer (for a price) -- or hoard and keep
secret -- only bare-bones information about any given dog -- name, parentage, color,
and any “championships” awarded by dog-show judges. There is no sense of
responsibility for the long-term soundness of the breed, or of service to owners and
would-be owners who are researching to find their next puppy or the perfect mate.

As part of the ESCʼs mission to conserve the ES breed, the registry database is a free
service. No one pays to either enter or view information in the dB. A dog need not be
registered with the ESC to be entered in the dB

But the ESCRdB cannot achieve its full potential without YOU. On the day a young
puppy is registered with the ESC, there is little specific information to record about him;
the important story of his work, health, and life history must be shared later, or lost
forever. Dogs who lived before the founding of the ESCRdB fade into a past where only
their names remain, and their stories and contribution to the breed are lost.

You can help protect the health and future of our breed by sharing as much honest
information about your current dogs, and dogs you have owned in the past, with the
registry.

Please supply as much information about your dog as you can. If you have documents
or information at home (such as health records, registration certificates, pedigrees) but
canʼt remember well enough to fill it in here, indicate that. A registrar will contact you by
email and you can send it in later.

You may fill out forms for dogs who are not present; a registrar will contact you to
request photographs. We encourage you to fill out forms for deceased English
shepherds that you have owned; itʼs especially valuable for studies of breed health
trends to know how long our lost friends were with us, what they died of, and what other
health issues they may have encountered in their lifetimes.

If you cannot fill out this form today at the Gathering, you may take it home to fill out,
and mail to: Rebecca Wingler, 3112 Olive Chapel Road, Apex NC 27502 or scan and
email it to registrar@esc-registry.org. You should also feel free to email good, clear
photos of your dog working, playing, and with his family to supplement the photos taken
today.
Date: Location:

Your name:

Email: Phone:

Address:

Is your dog registered with the ESCR? Y / N

Would you like to register him or her with ESCR? Y/N

(Regular registration is available to all purebred ES of known pedigree. Your dog does
NOT have to be registered with ESCR in order to be recorded in the database, but
registration offers many advantages. Breeding stock who donʼt meet the criteria for
regular registration may be registered via the Step-In procedure.)

ESCR registered name: Number:

UKC registered name: Number:

IESR registered name: Number:

Call name: Date of birth:

Sire:

Dam:

May a registrar contact you for more pedigree information if needed? Y / N

Dogʼs breeder: Address: (city/state)

Dogʼs color

Black/white sable/white clear sable/white tricolor black/tan

solid sable solid black solid clear sable saddle sable other:

Irish white markings “Excessive” white Piebald

Tail: long natural bob bobbed, unknown cause bobbed, surgical (cut)

Height (measured today):

Weight (measured today):

Spayed/Neutered Y / N If yes, at what age (in months):

Health testing

Has your dog been hip-radiographed and scored by the OFA? Y / N

Was the score: Excellent Good Fair Borderline Mild Moderate Severe
(OFA report or open registry will be required to enter this data into the dB)

Has your dog been hip-radiographed and scored by PennHIP? Y / N

DI: / DJD present: Y / N Cavitation: Y / N

(PennHIP report will be required to enter this data into the dB)

Has your dog been elbow-radiographed and scored by the OFA? Y / N

Were elbows normal? Y/N
(OFA report or open registry will be required to enter this data into the dB)

Is your dog MDR1: normal / normal (tested / by pedigree) mutant/normal

(tested) mutant / mutant (tested / by pedigree) unknown

(test report on your dog or the appropriate ancestors will be required for dB)

Has your dog had eyes examined and recorded by CERF? Y / N

Result:
(CERF report or open registry required to enter this data into the dB)

What illnesses or health conditions has your dog experienced? Include all serious
medical history except injuries (unless those injuries may have affected hip or eye
results, for example, or been caused by another health problem). Use the back of this
page if necessary. We are particularly interested in health issues that may have an
inherited component, such as allergies, siezures, arthritis, cancers, thyroid, retained
testicles, immune disorders. Please be as complete as possible. Remember, no
person or animal has perfect health, but we can only give our beloved dogs better
health by being honest about any problems in the current generation and the past.
What work does your dog do?

Working farm/ranch dog  Y/N

If yes, does dog: herd livestock guard livestock hunt game kill vermin 

Other Occupations

Family protector/guardian     Search & Rescue dog     Therapy dog     Companion dog    
Hobby herding dog Other:

Type of livestock worked (put approximate number of animals of each type that dog
regularly works after circling species)

Dairy cattle   Beef cattle   Sheep   Goats   Hogs  

Horses   Poultry Other:

Is your dog involved in competitions or other hobbies? Indicate below, with any titles,
certifcations, etc. your dog has earned, and from which organizations:

AWFA Herding Service / Assistance

Search and Rescue / Detection Obedience Rally Obedience

Freestyle Agility Flyball Temperament Test

Therapy Dog CGC / CGN Schutzhund / Protection

Other/ Details:

Please describe your dog in your own words on the back of this page. You can
write an esssay or just a list of descriptors, however you think best expresses what
makes your dog unique. Be as honest and critical as you can be about the dog you
love, but donʼt hesitate to describe your dogʼs particular strengths.

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Registrar use

Photo #ʼs / file names:

Entered by: Follow up by:

New registration Y / N Step-In prospect Y / N