Berner-Garde Database Personal Information Submission Form
This form is for updating your personal information stored in the Berner-Garde database. This information is kept in case a health researcher or Berner-Garde Operator would want to contact you for questions regarding an entry in the database.
For BMDCA members, this information is also used to maintain the membership directory as well as generate mailing labels for the Alpenhorn, Bulletin and other club mailings.
Please note that it is Berner-Garde policy to never supply anyone or organization with a list of names, phone numbers or email addresses of persons in the Berner-Garde database other than researchers or health studies approved by Berner-Garde or the BMDCA.
Enter your information here then click the "Submit Data" button to send the information to Berner-Garde.
My Personal Information
BG People ID:
Must be numeric
Optionally populate the form with your existing information
Last Name:
Middle Initial:
First Name:
Additional Names:
Address:
City:
State / Prov:
Alabama
Alaska
Alberta
Arizona
Arkansas
Armed Forces - America
Armed Forces - Europe, Africa & Middle East
Armed Forces - Pacific
Australian Capital Territory
British Columbia
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
N.W. Territory
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New South Wales (Australia)
New York
Newfoundland & Labrador
North Carolina
North Dakota
Northern Territory (Australia)
Northwest Territory (Canada)
Nova Scotia
Nunavut Territory (Canada)
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Quebec
Queensland (Australia)
Rhode Island
Saskatchewan
South Australia
South Carolina
South Dakota
Tasmania (Australia)
Tennessee
Texas
Utah
Vermont
Victoria (Australia)
Virginia
Washington
West Virginia
Western Australia
Wisconsin
Wyoming
Yukon
Postal Code:
Country:
-- Select --
Andorra
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Belarus
Belgium
Bermuda
Brazil
Bulgaria
Canada
Chile
China
Colombia
Costa Rica
Croatia
Czech Republic
Denmark
Dominican Republic
Ecuador
El Salvador
Estonia
Finland
France
Georgia
Germany
Gibraltar
Greece
Guatemala
Guernsey
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Japan
Kazakhstan
Kosovo
Latvia
Lithuania
Luxembourg
Macedonia (Republic of North)
Malta
Mexico
Moldova, Republic of
Montenegro
Morocco
Netherlands
New Zealand
Norway
Paraguay
Peru
Poland
Portugal
Puerto Rico
Romania
Russia
San Marino
Serbia
Slovakia
Slovenia
South Africa
Spain
Sweden
Switzerland
Taiwan
Turkey
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Uzbekistan
Phone:
Fax:
Email:
Personal Web Site:
(your own web site if you have one)
Kennel Name:
AKC Number:
Display Option:
Display all info
Do not display street address
Do not display street address, city and phone
Do not display full address and phone
Do not display full address, phone and email
Note that the display option allows you to control the display of
your
people data to general
database users. Operators or researchers will still be able to see all your info and contact you.
Bernese Mountain Dog
clubs I am a member of:
Additional Comments:
By clicking the "Submit Data" button below I am confirming that I am the person listed above. Furthermore, I am attesting that the data is correct and accurate to the best of my knowledge and that I voluntarily submit the above data for entry into the Berner-Garde database.
I authorize release in accordance with Berner-Garde policies and I authorize a Berner-Garde Operator to contact me for data validation purposes.
Please direct any questions or comments about this form to
manager@bernergarde.org
.