IABCA Registration Form
Please DO NOT use capslock. ALL CAPS are NOT allowed.
Email address *
Armband or Catalog #
(from a previous show, if available)
Breed *
Variety
If applicable
Dog's Full Registered Name *
Dog's Call Name or Nickname *
Current Registration # *
Club (IABCA,AKC,FCI, Other)
Sex *
Date of Birth *
MM
/
DD
/
YYYY
Color *
Breeder(s) *
Breeder's Location
General location is acceptable, ie. which state?)
Owner's Name(s) *
Owner's Address *
Mailing Address
Owner's City *
Owner's State *
Owner's Zipcode *
Owner's Phone # *
(digits only ie: 5035551212)
Sire 1 Name *
See the PEDIGREE CHART in the orange box on the right if needed.
Sire 1 Reg # *
If available
Dam 2 Name *
Dam 2 Reg #
If available
Sire 3 Name *
Sire 3 Reg #
If available
Dam 4 Name *
Dam 4 Reg #
If available
Sire 5 Name *
Sire 5 Reg #
If available
Dam 6 Name *
Dam 6 Reg #
If available
Sire 7 Name *
Sire 7 Reg #
If available
Dam 8 Name *
Dam 8 Reg #
If available
Sire 9 Name *
Sire 9 Reg #
If available
Dam 10 Name *
Dam 10 Reg #
If available
Sire 11 Name *
Sire 11 Reg #
If available
Dam 12 Name *
Dam 12 Reg #
If available
Sire 13 Name *
Sire 13 Reg #
If available
Dam 14 Name *
Dam 14 Reg #
If available
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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