LITTER REGISTRATION APPLICATION - United Kennel Club

[Pages:2]LIT TER REGISTRATION APPLICATION

The litter must be registered before it reaches one year of age. Both the Sire and Dam must be permanently registered with UKC in order to register a litter. You can register this litter online at

Step 1 - Litter Information (Required) Breed Step 2 - Sire Information (Required)

Total # Males Total # Females

Date of Breeding

Date of Birth

Normal Gestation Period is 63 days.

month

month

/

Step 3 - Dam Information (Required)

/

day

/

day

/

year

year

UKC #

UKC #

Was Frozen Semen Used? Yes No Date Collected for Freezing / /

Registered Name of Dam

Registered Name of Sire

Dam Registrant/Sole Signatory (Please print)

Sire Registrant/Sole Signatory (Please print)

Dam Registrant/Sole Signatory Signature (Required)

Sire Registrant/Sole Signatory Signature (Required)

Dam Co-Registrant (if applicable, please print)

Sire Co-Registrant (if applicable, please print)

Dam Co-Registrant Signature (Required, if applicable)

Sire Co-Registrant Signature (Required, if applicable)

Current Address

Current Address

City

State/Province

City

State/Province

Postal Code_________________ Country

Postal Code_________________ Country

Phone # (

)

Phone # (

)

Email Address

Email Address

Complete Step 4 ONLY if the Litter Registrant/Sole Signatory is not the Registrant/Sole Signatory of the Dam.

Step 4 - Registrant Litter Information (Optional)

Print the name of the Registrant/Sole Signatory to whom the litter is being registered Signature of the Registrant/Sole Signatory (Required)

Registrant/Sole Signatory (Only one individual may be listed as the Registrant/Sole Signatory)

Current Address

UKCis NOT responsible for undeliverable mail due to incomplete mailing addresses.

City

State/Province

Postal Code

Country

Phone # (

)

-

Email Address

This certificate is issued with the right to be corrected or revoked by the United Kennel Club. We reserve the right to change any and all rules, fees, etc. without notice. Prices are as of printing of this form. Visit for current pricing. Completed applications become the sole property of UKC, and will not be returned. Incomplete applications may result in processing delays. This application is being submitted for consideration and is not a guarantee of registration with UKC.

Litter App Regular Rev. 12-22

Step 5 - Permanent Registration of Pups (Optional) - By choosing to permanently register, you must name the puppy, provide the color, sex, and the Registrant/Sole Signatory's name and contact information.

Registration Packages Include: Certificate of Ownership with Pedigree and Easy Entry? card Expansion Packages Include: Upgraded Pedigree to 4-Generation Package and additional pedigree in size chosen

Sex

Dog Name

Color

Print the name of the Sole Signatory to whom pup is being registered.

Address

Phone (

)

-

Email

Variety City

Tattoo# / Chip Number

State/Province Date of Sale

Postal Code

/

/

Sex

Dog Name

Color

Print the name of the Sole Signatory to whom pup is being registered.

Address

Phone (

)

-

Email

Variety City

Tattoo# / Chip Number

State/Province Date of Sale

Postal Code

/

/

Sex

Dog Name

Color

Print the name of the Sole Signatory to whom pup is being registered.

Address

Phone (

)

-

Email

Variety City

Tattoo# / Chip Number

State/Province Date of Sale

Postal Code

/

/

Sex

Dog Name

Color

Print the name of the Sole Signatory to whom pup is being registered.

Address

Phone (

)

-

Email

Variety City

Tattoo# / Chip Number

State/Province Date of Sale

Postal Code

/

/

Sex

Dog Name

Color

Print the name of the Sole Signatory to whom pup is being registered.

Address

Phone (

)

-

Email

Variety City

Tattoo# / Chip Number

State/Province Date of Sale

Postal Code

/

/

Country

(If more than one individual is being listed on this dog's record, a Sole Signatory Form is required)

3-Gen Registration Package.....$30 4-Gen Registration Package..... +$4 5-Gen Expansion Package...... +$12 6-Gen Expansion Package......+$20 7-Gen Expansion Package......+$34

Country

(If more than one individual is being listed on this dog's record, a Sole Signatory Form is required)

3-Gen Registration Package.....$30 4-Gen Registration Package..... +$4 5-Gen Expansion Package...... +$12 6-Gen Expansion Package......+$20 7-Gen Expansion Package......+$34

Country

(If more than one individual is being listed on this dog's record, a Sole Signatory Form is required)

3-Gen Registration Package.....$30 4-Gen Registration Package..... +$4 5-Gen Expansion Package...... +$12 6-Gen Expansion Package......+$20 7-Gen Expansion Package......+$34

Country

(If more than one individual is being listed on this dog's record, a Sole Signatory Form is required)

3-Gen Registration Package.....$30 4-Gen Registration Package..... +$4 5-Gen Expansion Package...... +$12 6-Gen Expansion Package......+$20 7-Gen Expansion Package......+$34

Country

(If more than one individual is being listed on this dog's record, a Sole Signatory Form is required)

3-Gen Registration Package.....$30 4-Gen Registration Package..... +$4 5-Gen Expansion Package...... +$12 6-Gen Expansion Package......+$20 7-Gen Expansion Package......+$34

Step 6 - Shipping (Required) (When requesting a Rapid Services, you must address it ATTN: Rapid Services.)

Step 7 - Payment Information - Select one box below

Next Day Air (Available for physical mailing addresses only.) (Saturday delivery not available.)....................................................................... +$60 Expedited Service (Returned within five business days, with tracking number.) (Available in the Continental US only.)............................... +$40 Rush Service (Processed within five business days of receipt at UKC / Does not include time in transit).......................................................... +$30 Tube Mailing of Pedigree (Paperwork will come rolled in a protective tube instead of folded with tracking included.)............................ +$15 Standard First Class Mailing (Paperwork will come folded.)....................................................................................................................... +$0

Litter Registration .Up to 6 months - $34 6 months - 1 year - $68 ................................................. $

OR Permanent Registration of Pups Flat Fee Discount (Includes 3-Generation with Permanent Registration for 5 pups) Up to 6 months - $135 6 months - 1 year - $170 .............................................. $

GRAND TOTAL................................................................................................................ $

SUBMISSION INSTRUCTIONS

Credit Card Information (Major Credit Cards Accepted)

Checks and money orders must be payable in US funds,

Cardholder's Name

have the UKC Registration Number listed on the memo line and made to the order of:

United Kennel Club ? Attn: Registration ? 100 E. Kilgore Rd., Kalamazoo, MI 49002-5584

Billing Address

(269) 343-9020 ? registration@ ?

Please allow 4 to 6 weeks for processing.

Credit Card #

Exp.

No refunds will be issued due to an incomplete or illegible application.

Cardholder's Signature

Litter App Regular Rev. 12-22

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