Hybrid Litter Registration

Please fill out the form below and submit it.
Litter Registration is $7.00 plus $1.00 for each puppy.

"*" indicates required fields

Breed*

Date of Birth*

Number of Males*

Please enter a number greater than or equal to 0.

$7.00 Plus $1.00 per Puppy

Number of Females*

Please enter a number greater than or equal to 0.

Amount For Registration

Price:

Per males puppy price

Price: $1.00

Per Females puppy price

Price: $1.00

Total

Sire's ACHClub Name*

Sire's ACHClub Number*

Dam's ACHClub Name*

Dam's ACHClub Number*

Your Name*

Your Address*

Out of Country – Penalty

Price:

Your Phone Number

Your Fax Number

Your E-Mail Address*

ACHClub Breeder ID #*

Would You like to add a pedigree?*

($7.00 Plus $1.00 per Puppy)

Yes

Hidden

Total Amount For Pedigree

Amount For Pedigree

Price: $1.00

Do You Agree to all of the ACHClub's Terms and Conditions?*

Yes

Are You Selling direct To The Consumer? If Yes we will include a consumer pamphlet for each puppy*

Yes

Sire Information

Do You Also Own The Sire?*

Yes

Sire Owner's Name As Listed With ACHClub*

Sire Owner's ACHClub Breeder ID #*

Sire Owner's Address*

Sire Owner's Phone Number*

Sire Owner's E-Mail Address*

Miscellaneous

Additional Comments

Payment Information

Credit Card*

American Express

Discover

MasterCard

Visa

Grand Total

Hybrid Litter Registration