Dog Registration

Breed* -- Select Breed --AffenpinscherAfghan HoundAiredale TerrierAkitaAlaskan Klee KaiAlaskan MalamuteAmerican Black & Tan CoonhoundAmerican Bluetick CoonhoundAmerican BulldogAmerican EskimoAmerican Ori-PeiAmerican Pit Bull TerrierAmerican Rat TerrierAmerican Staffordshire TerrierAmerican Treeing WalkerAmerican WolfAnatolian Shepherd DogAppenzeller SennehundeArgentine DogoAustralian Cattle DogAustralian ShepherdAustralian Stumpy Tail Cattle DogAustralian TerrierAzawakhBasenjiBasset HoundBeagleBearded CollieBeauceronBedlington TerrierBelgian MalinoisBelgian SheepdogBelgian TervurenBernese Mountain DogBichon FriseBlackmouth CurBloodhoundBluetick CoonhoundBologneseBorder CollieBorder TerrierBorzoiBoston TerrierBouvier Des FlandresBoxerBoykin SpanielBraque Du BourdonnaisBriardBrittany SpanielBrussels GriffonBull TerrierBulldogBullmastiffCairn TerrierCanaan DogCane CorsoCao de Fila Sao MiguelCardigan Welsh CorgiCatahoulaCavalier King Charles SpanielCentral Asian SheepdogChesapeake Bay RetrieverChihuahuaChinese CrestedChinese Shar-PeiChow ChowClumber SpanielCocker SpanielCollieCoton de TulearDachshundDalmatianDandie Dinmont TerrierDoberman PinscherDogue De BordeauxDutch ShepherdEnglish Cocker SpanielEnglish CoonhoundEnglish PointerEnglish SetterEnglish ShepherdEnglish Springer SpanielEnglish Toy SpanielFila BrasileiroFinnish SpitzFlat-Coated RetrieverFox TerrierFrench BulldogFrench MastiffGerman JagdterrierGerman Shepherd DogGerman Shorthaired PointerGerman Wirehaired PointerGiant SchnauzerGlen of Imaal TerrierGolden RetrieverGordon SetterGreat DaneGreat PyreneesGreater Swiss Mountain DogGreyhoundHarrierHavaneseHovawartIbizan HoundIrish SetterIrish TerrierIrish Water TerrierIrish WolfhoundItalian GreyhoundJack Russell TerrierJago TerrierJapanese ChinKeeshondKerry Blue TerrierKomondorKuvaszLabrador RetrieverLagotto RomagnoloLakeland TerrierLandseerLeonbergerLhasa ApsoLlewellin SetterLowchenMalteseManchester TerrierMaremma SheepdogMastiffMi-kiMiniature Australian ShepherdMiniature Bull TerrierMiniature PinscherMiniature SchnauzerMountain TerrierNative American Indian DogNeapolitan MastiffNewfoundlandNorfolk TerrierNorwegian ElkhoundNorwich TerrierOld English SheepdogOlde BulldogPapillonPatterdale TerrierPekingesePembroke Welsh CorgiPerro De Pressa CanarioPetits Bassets Griffons VendeenPharaoh HoundPointerPomeranianPoodlePortuguese Water DogPugPuliRedbone CoonhoundRhodesian RidgebackRoman RottweilerRottweilerRussian Toy TerrierSaint BernardSalukiSamoyedSchipperkeScottish TerrierSealyham TerrierShetland SheepdogShiba InuShih TzuSiberian HuskySilken WindhoundSilky TerrierSkye TerrierSmooth Fox TerrierSoft Coated Wheaten TerrierSpitzStaffordshire Bull TerrierStandard SchnauzerTamaskan WolfdogTeddy Roosevelt TerrierTibetan SpanielTibetan TerrierTosa KenToy Australian TerrierToy Fox TerrierTreeing WalkerVizslaWeimaranerWelsh TerrierWest Highland White TerrierWhippetWire Fox TerrierXoloitzcuintleYorkshire Terrier

Registration Number*  –   –   – 

Pet Name*

Sire or Dam Name

Dog Color

Dog Sex* MaleFemale

Dog's Date of Birth* Day12345678910111213141516171819202122232425262728293031 MthJanFebMarAprMayJunJulAugSepOctNovDec Year200620072008200920102011201220132014201520162017201820192020

Is your dog neutered?* Yes No

New Owner Name*

Co-owner Name

Day Phone

Email Address

Country* -- Select a Country --AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua & BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanAzoresBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaireBosnia & HerzegovinaBotswanaBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCanary IslandsCape VerdeCayman IslandsCentral African RepublicChadChannel IslandsChileChinaChristmas IslandCocos IslandColumbiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCote D IvoireCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoryGabonGambiaGeorgiaGermanyGhanaGibraltarGreat BritainGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea BissauGuyanaHaitiHeard Island and McDonald IslandsHawaiiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea NorthKorea SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMidway IslandsMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNambiaNauruNepalNetherlands AntillesNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorwayOmanPakistanPalau IslandPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSerbia & MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSt HelenaSt Kitts-NevisSt LuciaSt MaartenSt Pierre & MiquelonSt Vincent & GrenadinesSudanSurinameSvalbardSwazilandSwedenSwitzerlandSyriaTahitiTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTurks & Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuelaVietnamVirgin Islands (Brit)Virgin Islands (USA)Wake IslandWallis & Futana IslandsWestern SaharaYemenZambiaZimbabwe

Address* Address Line 2

City*

State*

ZIP*

Previous Owner Name*

Address* Address Line 2

City*

State*

ZIP*

Look over the following options and choose what's best for you.

Packages 3-generation Package $50.00; Basic registration + 3-generation pedigree 4-generation Package $75.00; Deluxe Photo Package — Laminated photo registration + 4-generation laminated photo pedigree Premium Photo Package $100.00; Laminated photo registration, 2 wallet certificates, 5-generation pedigree with photo, and photo necklace pendant None Purchase ala carte See Pedigree Options below for photo upload.

Choose Your Certificate* Basic Included; Photo Option Breed Graphic $5.00; Breed Image Angel $5.00; Angel Graphic Patriot $5.00; Photo Option Old World Map $5.00; Photo Option Princess Pink $5.00; Photo Option Baby Blue $5.00; Photo Option

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Certificate Options Keep Blank or Use Default Emblem
Add My Dog's Photo$20.00

Certificate Photo

Add Microchip to Certificate $10.00

Microchip Number

Pedigree Options No Pedigree
4-generation Pedigree$35.00
5-generation Pedigree$45.00
Add Photo to Pedigree $20.00

Pedigree Photo

Grand Total $25.00

Add Photo Necklace Pendant $15.00

Necklace Photo

Would you like a free dog tag? YesNo

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