Designer Breed Registry Litter Application
Breed: ___________________________________________________Born:________/_________/____________
Males[ ] Females[ ]
Name of Sire:_________________________________________________
Breed__________________________________________Reg.#________________________(If known)
Name of Dam:___________________________________________________
Breed:__________________________________________Reg.#_______________________(_if known)
Owner of Litter
Name:________________________________________________DBR Breeder # (if known)___________________
Address:______________________________________________City:_____________________________________
Country/State:_________________________________________Postal/Zip Code:____________________________
Phone_______________________________ Email:___________________________________________________
Signature of Owner of Dam__________________________________________Date:__________________________
The Designer Breed Registry is not responsible for any misrepresentations or errors in this application a correction fee of $15.00
will be charged if the registration has already been issued and corrected copies sent to the applicant of this litter registration.
Method Of Payment
( ) Visa ( ) Master Card ( )Discover ( ) Amex ( ) PayPal ( )Check ( ) Money Order Total $25.00
Print name as it appears on credit card:
_______________________________________________________________________________
Credit Card # Exp.Date cvc code
________________________________________________ ______/______/_____ _____________
By signing below cardholder authorizes this charge
_________________________________________________________Date___________/____________/______________
Please make checks or Money Orders Payable to: Designer Breed Registry
Mail to: Designer Breed Registry
PO Box 238
Barryton, Michigan 49305 Phone: 1-732-256-9415
For online registration please take the secured link below
Breed: ___________________________________________________Born:________/_________/____________
Males[ ] Females[ ]
Name of Sire:_________________________________________________
Breed__________________________________________Reg.#________________________(If known)
Name of Dam:___________________________________________________
Breed:__________________________________________Reg.#_______________________(_if known)
Owner of Litter
Name:________________________________________________DBR Breeder # (if known)___________________
Address:______________________________________________City:_____________________________________
Country/State:_________________________________________Postal/Zip Code:____________________________
Phone_______________________________ Email:___________________________________________________
Signature of Owner of Dam__________________________________________Date:__________________________
The Designer Breed Registry is not responsible for any misrepresentations or errors in this application a correction fee of $15.00
will be charged if the registration has already been issued and corrected copies sent to the applicant of this litter registration.
Method Of Payment
( ) Visa ( ) Master Card ( )Discover ( ) Amex ( ) PayPal ( )Check ( ) Money Order Total $25.00
Print name as it appears on credit card:
_______________________________________________________________________________
Credit Card # Exp.Date cvc code
________________________________________________ ______/______/_____ _____________
By signing below cardholder authorizes this charge
_________________________________________________________Date___________/____________/______________
Please make checks or Money Orders Payable to: Designer Breed Registry
Mail to: Designer Breed Registry
PO Box 238
Barryton, Michigan 49305 Phone: 1-732-256-9415
For online registration please take the secured link below
| Spayed Neutered Unknown Origin |
| Titles |
Online Litter Registration
The DBR is not responsible for owner errors
when filling out this online registration a correction
fee of $15.00 will apply if the registration has issued
and must be re issued.
when filling out this online registration a correction
fee of $15.00 will apply if the registration has issued
and must be re issued.
