Application For Dog Registration

POSTAL MONEY ORDER ONLY--NO CHECKS WILL BE ACCEPTED Send this certificate and proper fees to:  

Bull Breeds Coalition
Box 375
Marysville, KS 66508

  Phone: (785) 562-6088......or......(785) 562-7864
Website: www.shortybull.com   BBCR reserves the right to cancel or revoke registration of this dog if any statements on this certificate are found to be untrue.

Print and complete this form

 

Before any BBCR Certified Pedigrees will be issued for a litter, the Sire and Dam each must have a PHOTO and BBCR CERTIFIED PEDIGREE with an BBCR REGISTRATION NUMBER filed at our BBCR Headquarters, Marysville, KS. 66508

 A PHOTO OF YOUR DOG MUST BE ATTACH TO THIS APPLICATION IN ORDER TO BE REGISTERED

 

 

Dog Registration Fee - $25.00     
 

Dog Information:

 
BREED _________________________________

DOB:

 _________________________________
COLOR _________________________________

SEX:

 _________________________________
SIRE: _________________________________

REG #

 _________________________________
DAM: _________________________________

REG #

 _________________________________
 
Breeder's Information
 
FIRST _________________________________ LAST _________________________________
ADDRESS ____________________________________________________________________________
CITY _______________________ STATE ________ ZIP ________ PHONE ________________________
 
New Owner's Information
 
FIRST _________________________________ LAST _________________________________
ADDRESS __________________________________________________________________________
CITY _______________________ STATE ________ ZIP ________ PHONE ________________________

NAME OF REGISTERED ANIMAL:____________________________________________________
                                                                                (name not to exceed 30 Letter/Spaces)


COLOR: ________________________________________________     SEX:     Male / Female

 

I, ______________________________________, declare that to the best of my belief and knowledge, the information on this application is true and correct.