North Australian Canine Association (Inc)
Trading as DOGSNT
A member Body of the Australian National Kennel Council
PO Box 37521, Winnellie NT 0821 Ph: 8984 3570 Fax: 8984 3409
Email: naca3@bigpond.com website: dogsnt.com.au
BREED:
BREEDERS PREFIX:
SIRE:
SIRE’S REGISTRATION NUMBER:
DAM:
DAM’S REGISTRATION NUMBER:
BREEDER:
BREEDER’S MEMBERSHIP NUMBER:
SIRE’S OWNER:
SIRE’S OWNER’S MEMBERSHIP NUMBER:
DATE OF MATING:
1.
2.
3.
4.
5.
NOTE: OWNERSHIP OF THE KENNEL PREFIX AND THE DAM MUST BE IDENTICAL AND LINKED TO A
FINANCIAL MEMBERSHIP
DATE OF BIRTH:
Breeders must be a resident of the Northern Territory and be a member of the North Australian Canine Association.
A Northern Territory residential address, not a PO Box, must be linked to the breeders prefix.
A dogs name must not exceed 30 characters including prefix.
Certain words are not permitted as common names. These words including already registered prefixes, are “OF”, “CHAMP”, “IMP” and numbers (eg I, IV etc), hyphens and apostrophy’s.
It is mandatory that Dogs NT Membership number must be include in any advertising of puppies whatever the media.
NO.
FIRST CHOICE NAME
SECOND CHOICE NAME
Must be Supplied
MAIN OR
LIMITED
SEX
D/B
COLOUR/MARKINGS
As per ANKC breed standards eligible colours &
markings
MICROCHIP NUMBER
No handwritten microchip numbers
1
2
3
4
5
6
7
8
9
10
POSTAL ADDRESS
POSTCODE
TELEPHONE CONTACT DETAILS IN CASE OF DIFFICULTIES
I CERTIFY THAT ALL INFORMATION IS CORRECT AND AGREE TO THE
PUBLICATION OF THIS LITTER (all owners must sign)
Application for Litter Registration - Version 2 – October 2015
SIGNATURE
SIGNATURE
Page 1 of 2
SERVICE CERTIFICATE
(To be completed by the owner of the Sire or Frozen Semen and counter signed by the owner of the Dam)
BEING FINANCIAL MEMBER/S OF:
I/WE
Being the Sire’s Owner/s
Being the Owner of the Frozen Semen (cross out which is not applicable)
MEMBERSHIP NUMBER:
ADDRESS:
POSTCODE:
CERTIFY THAT THE BITCH:
BITCH REGISTRATION NUMBER:
WAS SERVED BY
SIRE REGISTRATION OR SEMEN
REGISTRATION NUMBER:
(Insert Sire’s Name):
ON DATE OF MATING:
SIGNATURE OF SIRE/SEMEN OWNER/S:
All must sign unless prior arrangements have been
made and lodged with the Owner’s Controlling Body
OWNER/S OF DAM COUNTER
SIGNATURE/S:
SIGNATURE
SIGNATURE
SIGNATURE
SIGNATURE
NOTE:
An application of registration may be lodged at any time within eighteen (18) calendar months of the date of whelping.
An application received must accompany the current fees. Fees are available on the DogsNT website
http://www.dogsnt.com.au
The owner/s of the sire or the owner of the frozen semen should complete all details of the Service Certificate and this must be
countersigned by the owner/s of the bitch.
Overseas registered sires or dams must be re-registered on the Australian Canine Computer (ANKC) system before the
litter can be registered.
ARTIFICIAL INSEMINATION:
If the dogs to which this application relates have been subject to “AI” it is necessary
for the Veterinary Surgeon who performed the AI to sign the following declaration:
I__________________________________________________________________
(Veterinary Surgeon)
Certify that I artificially inseminated the above mentioned bitch with semen taken from
the above mentioned sire.
Imported semen or semen from non-Australian resident sires must be re-registered on the Australian Canine Computer
(ANKC) system before the litter can be registered.
SIGNATURE:
All dogs in the litter must be registered. Any dogs not included in this application may cease to be eligible for registration.
DATE:
Application for Litter Registration - Version 2 – October 2015
Page 2 of 2