IABCA Registration Form
Please DO NOT use capslock. ALL CAPS are NOT allowed.
Email address *
Armband or Catalog #
(from a previous show, if available)
Your answer
Breed *
Your answer
Variety
If applicable
Your answer
Dog's Full Registered Name *
Your answer
Dog's Call Name or Nickname *
Your answer
Current Registration # *
Your answer
Club (IABCA,AKC,FCI, Other)
Your answer
Sex *
Date of Birth *
MM
/
DD
/
YYYY
Color *
Your answer
Breeder(s) *
Your answer
Breeder's Location
General location is acceptable, ie. which state?)
Your answer
Owner's Name(s) *
Your answer
Owner's Address *
Mailing Address
Your answer
Owner's City *
Your answer
Owner's State *
Owner's Zipcode *
Your answer
Owner's Phone # *
(digits only ie: 5035551212)
Your answer
Sire 1 Name *
See the PEDIGREE CHART in the orange box on the right if needed.
Your answer
Sire 1 Reg # *
If available
Your answer
Dam 2 Name *
Your answer
Dam 2 Reg #
If available
Your answer
Sire 3 Name *
Your answer
Sire 3 Reg #
If available
Your answer
Dam 4 Name *
Your answer
Dam 4 Reg #
If available
Your answer
Sire 5 Name *
Your answer
Sire 5 Reg #
If available
Your answer
Dam 6 Name *
Your answer
Dam 6 Reg #
If available
Your answer
Sire 7 Name *
Your answer
Sire 7 Reg #
If available
Your answer
Dam 8 Name *
Your answer
Dam 8 Reg #
If available
Your answer
Sire 9 Name *
Your answer
Sire 9 Reg #
If available
Your answer
Dam 10 Name *
Your answer
Dam 10 Reg #
If available
Your answer
Sire 11 Name *
Your answer
Sire 11 Reg #
If available
Your answer
Dam 12 Name *
Your answer
Dam 12 Reg #
If available
Your answer
Sire 13 Name *
Your answer
Sire 13 Reg #
If available
Your answer
Dam 14 Name *
Your answer
Dam 14 Reg #
If available
Your answer
Online Certification & Authorization : Ownership and Certification *
Person who currently owns the dog and applies for registration must complete this section. I hereby certify that, to the best of my knowledge and belief, the information contained in this application is true and correct and that the ancestors are of the same breed as the dog sought to be registered. I agree to abide by IABCA of America Registry Rules and Regulations.
Required
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