American Purebred Kennel Club
Registration of a Purebred Dog Form
Americanpurebredkennelclub.com
Name of Dog
Sex _____ Date of Birth __________ Breed________________________________________________________
Color _________________ Markings ______________________________________________________________
If your dog was previously registered, attach a copy of the pedigree for verification of breed. If your dog has not been
previously registered, then your dog will need to have a witness signatures and you will need to send in 3 pictures of your
dog (front, left side view & Right side view). You can mail the photos in or email them to registration@americanpurebredkennelclub.com
Witness name_______________________________ Witness Signature _______________________________
Witness Phone Number (___)____-_____
If known
SIRE________________________________
SIRE_____________________________
DAM_______________________________
SIRE________________________________
DAM_____________________________
DAM_______________________________
Owner (print) ___________________________________ Signature______________________________________
Co- Owner (print) _______________________________ Signature______________________________________
Address___________________________________________________City________________________________
ST____ Zip_______Telephone (____)____ -____ Email Address______________________________@_________
___$24.00 – Registration with 3-Generation Pedigree ___$19.00 – Basic Registration - Sire & Dam only listed
___$34.00 – Registration with 4-Generation Pedigree ___$44.00 – Registration with 6-Generation Pedigree
___BREEDERS FREE ADULT BASIC REGISTRATION
TOTAL $_________
Pay by Money Order, Debit Card or Credit Card (Make Money Order payable to American Purebred Kennel Club)
ALL FEES PAID ARE NONREFUNDABLE
Card Number
Exp Date
Coad
Cardholder Name___________________________________Signature______________________________________
For questions please call 210-409-9850
Mail To P.O. Box 689 McQueeney, Tx 78123 or Scan & email to registration@americanpurebredkennelclub.com