Application For Single Dog Registration Or Dual Registration
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Dog Information
  • - select a option -
  • Male
  • Female
Color (see color chart for reference)
Date of Birth
Registered Name Desired (Limit 25 characters)
Second Choice (Limit 25 characters)
Call Name
Chip ID or Tattoo #
This dog was produced as a result of:
One front view photo of dog
Please Upload one jpg, jpeg, png, gif or pdf
One side profile photo of dog
Please Upload one jpg, jpeg, png, gif or pdf
Owner First Name
Owner Last Name
Owner Address
Owner Email Address
Owner Phone Number
State/Province and Country
Zip Code
Breeder First Name
Breeder Last Name
Breeder Address
State/Province and Country
Zip Code
Are you applying for Dual Registration?
Organization Where Dog is Currently Registered
To apply for Dual Registration please attach a copy of the other organizations (example UKC, AKC), registration certificate and pedigree. The certificate must show you as the current owner.
Registration Certificate (Only Needed for Dual Registration)
Please Upload jpg, jpeg, png, gif, pdf
Please upload your registration certificate from other registry.
Your Dog's Pedigree (Only Needed for Dual Registration)
If you have a Single Dog Application form with signatures please upload here
Please upload a copy of your pedigree from other registry
Web Link to Your Dog's Online Pedigree if Available
To complete the registration process, verification will need to be received from the owners of both the sire and the dam. This may process may be completed through email verification if necessary.
Signature of Dog Owner
Dog's Pedigree
Sire Name and ADBA#
If the Sire is ADBA Registered, sire owner must verify this information.
Owner Name
Owner Phone Number
Owner Email
Dam Name and ADBA#
If the Dam is ADBA Registered, Dam owner must verify this information
Owner Name
Phone Number
Dam 6
Registration Options
Additional Services
Processing and Shipping Options
Donate to Fight Breed Specific Legislation
Donation Amount
Total Due

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