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Registration
Application for Dogs already registered with other registries.
**You must send a COPY of your dog's other registration with this application.
This application and supportive
evidence become the property of |
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Name of dog for registration: |
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| Other Registry: | Registration No: | ||
| Sex: (circle) Male Female | Date of Birth: | ||
| Breed of Dog: | Color: | ||
| Sire's Name: | Registry & No: | ||
| Dam's Name: | Registry & No: | ||
| Breeder's Name: | Street Address: | ||
| City, State | Zip Code: | ||
| Your Name: | E-mail Address | ||
| Street Address: | |||
| City, State, and Zip Code: | |||
| Pedigree Information: Fill out as much as possible, it is not necessary to complete all lines. | |||
| Sire's
Sire: |
Name: |
Color: |
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Registry & No: |
Country: |
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| Sire's Dam: |
Name: | Color: | |
| Registry & No: | Country: | ||
| Dam's Sire: |
Name: | Color: | |
| Registry & No: | Country: | ||
| Dam's Dam: |
Name: | Color: | |
| Registry & No: | Country: | ||
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Please read the following statement and sign and date this form where indicated. "I hereby certify that I am the owner of the dog described herein, and that all information I have given is correct, and to the best of my knowledge." |
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| Signature of Owner | Date: | ||
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Send this application with a copy of the dog's current registration and fee of $12.00 (twelve dollars) per dog to: "AMW " P.O. Box 7234 Huntington Beach, CA 92615 and we will issue registration certificate in your name, mailed directly to you. *** You may photo-copy this form if you have more than one dog to register at this time. |
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AMW
Kennel
Club and Registry