Home
Obedience Title Application
All dogs participating in the program for an Obedience Title must be registered with the Designer Breed Registry/DBR.If
your dog is not registered with the DBR you can submit an application for individual registration with the required fee
along with this application. All video's of dogs and applications become the property of the Designer Breed Registry.

Obedience Title testing for this application____________________________________________________

Breed:___________________________________________DBR Registration#______________________

Name of Dog:__________________________________________________                   (  )male    (   ) female

Owners Name:________________________________________________________________

Address:_____________________________________________________________________

City:_______________________________________State/Country:__________________Zip:____________

Phone:(area code first)_______________________Phone: (area code first)______________________

Method of Payment:(   )Visa    (   )Master Card     (    ) Discover  (   )Check    (   )MO          
    Total Fee $25.00
                                                              
Name on credit card(please print)_________________________________________________

Credit Card Number__________________________________________Exp.Date_____/_____

Cardholder authorizes this charge

Signature of card holder__________________________________________Date____/____/______

Mail Payment and Video to:                         Designer Breed Registry
Phone:1-732-256-9415                                       PO BOX 474
                                                             Farmingdale, New Jersey 07727