Weser-Ems Ponies and Horse Breeder’s Society Department North America of Pferdestammbuch Weser-Ems e.V. Foal / Yearling Registration Form Reg.no.: filly Please only complete this section! Registration of birth Inspection site: site Date of birth: MM.DD.YYYY Name of the foal: and Date: MM.DD.YYYY in: USA colt Canada Last breeding date: MM.DD.YYYY name of the foal Color: color Dam Reg.no.: Sire: reg.no.of dam name of sire Dam: name of dam name of dam's sire Dam’s sire: Sire Reg.no.: reg.no.of sire Breeder: owner of the dam at date of breeding Owner: owner of the foal at date of inspection Farm: name if applicable Mailing adress: mailing City: city, State: address st, Zipcode: zipcode Business phone. business Mobile phone: mobile phone phone Fax: Home phone: fax E-Mail: e-mail Official use only! home phone Membership number: brandet: Microchip: DNA: Premium Award: Birth Certificate: Fees Color/markings: Comments: USD or CAD inspection $ registration fee $ annual fee $ membership 2016 $ membership 2017 $ single breeding permit $ $ Registration confirmed Dokument4 Dokument4 Dokument4 (seal) Signature • Weser-Ems Ponies and Horse Breeders Society • Contact: Heike Arends Bastian Scharmann membership paid check number: cash $ Total sum: $ Date: • Grafenhorststrasse 5 • e-mail: arends.heike@oldenburger-pferde.com • e-mail: scharmann.bastian@oldenburger-pferde.com - - - Form has to be e-mailed - - - • 49377 Vechta (Germany) • Phone: 011 49 160 906 159 96