World Kennel Club®

Cliff Culp, President
P.O. Box 60771 * Oklahoma City, OK 73146 * (405) 745-9520

Litter Registration Application

Void After 12-31-08

Litter Registration Fee: $25.00 
If sending currency other than U.S. funds, there will be an additional fee of $10.00 per check or money order.
Fill out and PRINT using all CAPITAL letters to register a litter with WKC®.
Send application to P.O. Box 60771, Oklahoma City, Oklahoma, 73146.
 
Breed:________________________________________________________________

Place of birth of litter: City:_______________________________________

State:____________ Zip:_________________

Date of litter birth:______________Date of breeding:__________________

Number of living dogs in this litter: Male_____ Female_____

Owner of litter:___________________________________________

Address:___________________________________________________

City:__________________________ State:______ Zip:__________

Owner of Sire:______________________________________________

Address:___________________________________________________

City:__________________________ State:______ Zip:__________

Owner of Dam:_____________________________________________

Address:___________________________________________________

City:__________________________ State:______ Zip:__________

Registration name of sire:_________________________________

Number of Sire:_______________________

Registration name of Dam:__________________________________

Number of Dam:______________________
If the sire or dam is registered with another organization, a copy of that certificate must be attached.

I, the owner of this litter apply to W.K.C.® to register this litter of pure breed dogs with W.K.C.® and was the owner of the sire and dam at the time of mating. 

(Please sign)     Owner of Sire:________________________Telephone:___________________

(Please sign)     Owner of Dam:________________________Telephone:___________________

Please check one of the following:  I was present at time of mating.  Yes__ No__
These dogs are pure breed and I will continue to breed pure. I understand for any misrepresentation made by me that the World Kennel Club® has the right to revoke the registration of my dogs and may result in loss of all W.K.C.® privileges. PLEASE NOTE: If the sire or dam is registered with another organization; a copy of that registration certificate must be attached.
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