World Kennel Club®

REGISTRATION APPLICATION

Cliff Culp, President

Print Only | Fill in and return to W.K.C.®                                              VOID after 12-31-08
Choose two names for your dog. List your first choice, then second.
 

SEND PHOTOGRAPH - Front and Side View Required! 

1st Choice:_______________________________________________________ _____

2nd Choice:_______________________________________________________ _____

Breed:____________________________________ Color:______________________

Sex:_________________

Date of Birth:______________________ Date Returned:____________________

Sire:____________________________________

Dam: ____________________________________

Breeders Name:_________________________________________________________

Address:______________________________________________________ _________

City:________________________________ State:_____ Zip:_________________


           $20.00 per application.     Please send S.A.S.E.

If sending currency other than U.S. funds, there will be an additional fee of $10.00 per check or money order.
WKC® reserves the right to cancel this application for cause of error or misrepresentation by any party. By signing below, you're stating your dog is pure and will continue to breed pure.

Print Owner's Name:________________________________________________________

Owner's Signature:____________________________________________________ _____

Print Address:______________________________________________________ _______

Print City:_____________________________ State:_____ Zip:__________________
*This application cannot be used for transfer of ownership of dog. It must be returned to W.K.C.®  for         registration of present owner.

World Kennel Club®
P.O. Box 60771
Oklahoma City, OK 73146

SEND PHOTOGRAPH - Front and Side View Required!