National Kennel Club®
Application to Register A Purebred Dog
www.nationalkennelclub.com
PO Box 331
Blaine, TN 37709
865-932-9680
865-932-2572 fax
PLEASE PRINT CLEARLY AS WE CANNOT BE RESPONSIBLE FOR ERRORS.
If a single name dog is listed the owner’s last name will be added to the dog.
Name of Dog___________________________________________________ Breed_________________________________
(Do not use over 24 letters and spaces)
Sex_________ Date of Birth _______________________ Color and Marking______________________________________
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 be inspected by either a veterinarian or licensed NKC breed inspector and
you will need to send in 2 pictures of your dog (front & side view).
Inspected by________________________________ Title/ License #___________________ Date______________________
Include NKC # s if available.
SIRE_______________________________
SIRE________________________________
DAM_______________________________
SIRE_____________________________
SIRE_______________________________
DAM________________________________
DAM_______________________________
SIRE_______________________________
SIRE________________________________
DAM_______________________________
DAM_____________________________
SIRE_______________________________
DAM________________________________
DAM_______________________________
**If your dog has a micro chip or you have its DNA papers, attach a copy of the records for the registration. **
DNA Number
Micro Chip Number
Check if new address.
I certify that I am the owner of the above dog and that this information is correct
Owner (print clearly) _____________________________________ Signature______________________________________
Co-Owner
Signature
Street Address_____________________________________________________City________________________________
ST
Zip
Telephone (
)
-
Email Address
NKC Fees payable in US funds by check, money orders or credit card. Check appropriate box(s) below.
*All Faxed and Emailed Applications will be charged the Rush Service Fee Effective 8-1-13
$23.00 - Registration Fee for up to 3-Generation Pedigree
$18.00 - Basic Registration - Sire & Dam only listed
$ 8.00 - Optional Quick Entry Card
$25.00 - Optional Photo Entry Card
$15.00 - Optional Rush Service - The rush service only expedites the processing of paperwork through the NKC office.
Additional fees required for overnight or priority mail services. Contact the NKC office for these fees.
$15.00 - Out of Country Processing Fee
Total amount enclosed $ _________
Exp Date
Card Number
V code
(last 3 numbers in signature
panel on back of card)
Card Holder Signature
For God so loved the world, that he gave his only begotten son,
that whosoever believeth in him should not perish, but have everlasting life. John 3:16