| PUREBRED KENNEL CLUB OF AMERICA | |
| 1300 Shepard Lane, Loving, TX 76460 (940) 378-2537 | |
| APPLICATION FOR REGISTRATION | |
| Visit us at pkcamerica.com |
| Purebred Kennel Club of America looks forward to registering your pet. Along with providing you with a cerficate of |
| registration, PKCA also provides a permanent record service. Your pet's registered name as well as the application is kept |
| in our records. This allows you to start your pet's family tree. |
| Registering your pet can make it more valuable, especially if you decide to raise and sell pets. |
| PKCA is not affiliated in any way with any other organization. Liability is limited to the refund of the application fee. |
| To register your pet: | 1. | Choose your pet's name, then | |
| 2. | Fill in your name and address and | ||
| 3. | Send this application with a $20.00 registration fee to PKCA. | ||
| Registration Fee: | 4. |
Check or Money Order, |
|
| $20.00 | 5. | Please Print or Type Information. | |
| This will help reduce errors. | |||
| Name of your pet | Limit to 35 Characters | Date of Birth |
| / / |
| Sex | Breed | Color | Markings |
| Sire | (your pet's Daddy) | Dam | (your pet's Mommy) |
| Color | Markings | Color | Markings |
| Organization & Registration Number | Organization & Registration Number |
| Buyer's Name | Breeder's Name |
| Buyer's Street Adress | Apt/Suite | Breeder's Street Address | Apt/Suite |
| City | State | Zip | City | State | Zip |
| Telephone Number (including area code) | Telephone Number (including area code) |
| I certify that the above named and described animal is a full-blooded respresentative of the breed I have indicated, and that |
| all information I have provided on the application is true and correct to the best of my knowledge. I am applying |
| to Purebred Kennel Club of America to issue a registration certificate from the facts I have provided. |
|
|
|
| Buyer's Signature | Date | Breeder's Signature | Date |
|
Feel free to copy this form or
contact PKCA for additional form. |
|
Edward Dunbar, Field Manager
400 Perkins Road, Poolville, TX 76487
(817) 341-1125 |
| Back | Reset |