DESIGNER BREED REGISTRY
STANDARD LITTER REGISTRATION FEE - $25.00
NAME OF LITTER OWNER *
Your answer
MAILING ADDRESS *
Your answer
PHONE NUMBER *
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EMAIL ADDRESS *
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BREED OF LITTER *
Your answer
NUMBER OF MALES IN LITTER *
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NUMBER OF FEMALES IN LITTER *
Your answer
I AM CHOOSING ONE OR MORE OF THE FOLLOWING OPTIONS
IF ADDING PICTURES TO THE LITTER CERTIFICATE A REPRESENTATIVE WILL ADVISE YOU ON SENDINGA PICTURE
DATE OF BIRTH OF LITTER *
Your answer
BREED OF SIRE OF LITTER *
Your answer
NAME OF SIRE *
Your answer
IF SIRE IS REGISTERED PLEASE ENTER THE REGISTRY NAME AND THE DOGS REGISTRATION NUMBER *
If the sire is not registered please fill the field in with NO
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OWNERSHIP OF THE SIRE *
BREED OF DAM *
Your answer
NAME OF DAM *
Your answer
IF THE DAM IS REGISTERED PLEASE ENTER THE REGISTRY NAME AND THE DOGS REGISTRY NUMBER *
Your answer
MORE OPTIONS IF REGISTERING THE SIRE AND DAM OF LITTER
METHOD OF PAYMENT *
CREDIT/DEBIT CARD NUMBER
Your answer
EXPIRATION DATE *
Your answer
CVC CODE *
Your answer
NAME AND ADDRESS FOR CREDIT CARD IF DIFFERENT THAN NAME AND ADDRESSS ENTERED AT BEGINNING OF FORM
Your answer
PAYPAL EMAIL ADDRESS FOR INVOICING
Your answer
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