PUREBRED KENNEL CLUB OF AMERICA
1300 Shepard Lane, Loving, TX 76460 (940) 378-2537
APPLICATION FOR REGISTRATION
Visit us at pkcamerica.com

 

Purebred Kennel Club of America looks forward to registering your pet.   Along with providing you with a certificate of registration

PKCA also provides a permanent record.  Your pet's registered name as well as the application is kept in our records.  This allows you

to start your pet's family tree.  Registering your pet can make it more valuable, especially if you decide to raise and sell pets.

	To register your pet:	1.	Choose your pet's name, then
		2.	Fill in your name and address and
		3.	Send this application with a $20.00 registration fee payable to PKCA.
Registration Fee:		4.	Check or Money Order, no cash please.
$20.00		5.	Please Print or Type Information.
			This will help reduce errors.

Name of your pet

Limit to 35 Characters

Date of Birth

/ /

Sex

Breed

Color

Markings

Sire

(your pet's Daddy)

Dam

(your pet's Mommy)

Color

Markings

Color

Markings

Organization & Registration Number

Organization & Registration Number

Buyer's Name

Breeder's Name

Buyer's Street Adress

Apt/Suite

Breeder's Street Address

Apt/Suite

City

State

Zip

City

State

Zip

Telephone Number          (including area code)

Telephone Number          (including area code)

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I certify that the above named and described animal is a full-blooded respresentative of the breed I have indicated, and that

all information I have provided on the application is true and correct to the best of my knowledge.  I am applying

to Purebred Kennel Club of America to issue a registration certificate from the facts I have provided.

Buyer's Signature

Date

Breeder's Signature

Date

Feel free to copy this form or contact PKCA for additional forms.

PKCA is not affiliated in any way with any other organization.  Liability is limited to the refund of the application fee.