Single Permanent Registration

Owner information

First Name (required)

Last Name Name (required)

Address(required)

City(required)

State(required)

Zip(required)

Country(required)

Your Email (required)

Phone (required)

Breeder information

First Name (required)

Last Name (required)

Address(required)

City(required)

State(required)

Zip(required)

Country(required)

Your Email (required)

Phone (required)

Dog Information

Name(required)

Dogs sex (required):  Male Female

D.O.B(required)

Color(required)

Breed(required)

Reg#(required)

Sire Information

Name and registration number(required)

D.O.B(required)

Color(required)

Breed(required)

Reg#(required)

Dam Information

Name and registration number(required)

D.O.B(required)

Color(required)

Breed(required)

Reg#(required)

Additional Information

I certify that all information provided on this form is true and correct to the best of my knowledge. If you have received a temporary litter registration form you must send it in for processing. If you do not have the authorization of the person(s) you purchased your dog from to register it then your application will be denied. Your application for single registration must be accompanied by a copy of the dogs permanent registration including the pedigree. Incomplete forms will not be processed.