REGISTRATION HALL OF FAME K9'S Pedigree Application Owner's Name Prefix First Last Suffix Owner's Email Owner's Phone# ###-###-#### Owner's Address Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country Co-Owners Name (If applicable ) Prefix First Last Suffix Co-Owners Email Co-Owners Phone # ###-###-#### Co-Owners Address Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country Dogs Name Birthdate (Month/Day/Year) Color Breed Gender Have you completed all prior REQUIREMENTS before starting this application? Please selectyesno Is Your Dog Mircochiped? Please selectyesno Microchip # Dog's Registries/Clubs Club / Registry #'s Sire's Name Sire's Registries/Clubs Club / Registry #'s Sire's SIRE Sire's DAM Sire's Sire's Sire Sire's Sire's Dam Dam's Name Dam's Registries/Clubs Dam's Sire Dam's Dam Dam's Sire's Sire Dam's Dam Dam Checkbox ABKC ABR EBKC CBKC UKC TCBR IBKC IBR WBR USBR PBKC HOFK9S BULLYDEX BULLY PEDIA BULLY PEDEX REGISTRATION FEE $100.00 SHIPPING 5-7 DAYS US ONLY (FREE) 2-5 DAYS $40.00 1-2 OVERNIGHT $80.00 INTERNATIONAL $100.00
