Breed:_______________________________________________________Date Of Birth:_________/______________/____________ Sex:( )Male ( )Neutered ( )Female ( )Spayed Color:______________________________________ Sire's Name:__________________________________________________Sire's Number if applicable:____________________________ Dam's Name:_________________________________________________Dam's Number if applicable:___________________________ Dogs Name:_|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___| Please print clearly in the above boxes. names are subject to the approval of the American Dog Federation |
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| Registrant Information Owners Name:_________________________________________Co Owner:______________________________________ Address:_________________________________________________________________City:________________________ Country/State:_________________________________Postal/Zip Code:_________________Phone:____________________ Signature Of Owner:___________________________________Co Owner:___________________________________ Payment Method (1) $20.00 Single Dog Option(2) 3-5 dogs $12.00/dog Option(3) over 5 dogs $7.00/dog ( )Visa ( ) Master Card ( ) Check ( )Money Order Total$________________ Print name as it appears on credit card_____________________________________________________________________ Credit Card #_________________________________________________Expiration Date:________/_________/_________ By Signing Below the credit card holder authorizes the above charges to be charged to the credit card account number above Signature:___________________________________________________________Date:__________________ This is a Printable Page Please send payment with the completed application to: American Dog Federation 20785 30th Avenue Barryton, Michigan 49305 |
| American Dog Federation Registration Application |