American Belgian Blue Breeders, Inc. American Belgian Blue Breeders, Inc. Multiple Registration Application P.O. Box 633404 Nacogdoches, TX 75963 Required fields are indicated by an asterisk (*) Type in the information on the application. In the sections that have several options either highlight or underline the correct option. After completing the application save the copy to your computer and email the application to the office at info@belgianblue.org. Registrations will not be completed until payment is received. Member Number: Herd Prefix: *First Name: *Last Name: *Address: *City: *State: *Phone e-mail: Animal 1 *Zip Rush registration *Name: ET Not ET Yes No (additional fee below) %Belgian: *DOB: Birth Weight: Color: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 (for color definitions see below) Sex: Bull Twin: Yes No (please circle one) *RE Tattoo: *LE Tattoo: Calving Ease: Horned: Horned Polled Scurred Natural Blood Case#: Some assistance Lab Name: ImmGen Cow Steer * DNA Kit: Yes No Mechanical assistance Canadian Belgian Sire Name/Breed: Reg #: %Belgian Circle One: ABBB BBBI Canadian Belgian No Registration# Dam Name/Breed: Reg #: Transfer On Entry C-section %Belgian Circle One: ABBB BBBI Canadian Belgian No Registration# Name: Address: Member#: *City: *State: Animal 2 Rush registration *Name: ET Not ET *Zip Yes No (additional fee below) %Belgian: *DOB: Birth Weight: Color: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 (for color definitions see below) Sex: Bull Cow Twin: Yes No (please circle one) *RE Tattoo: *LE Tattoo: Calving Ease: Horned: Horned Polled Scurred Blood Case#: Natural Some assistance Lab Name: ImmGen Steer *DNA Kit: Yes No Mechanical assistance Canadian Sire Name/Breed: Reg #: Circle One: ABBB BBBI Canadian Belgian No Registration# %Belgian Circle One: ABBB BBBI Canadian Belgian No Registration# Name: Address: *City: Belgian %Belgian Dam Name/Breed: Reg #: Transfer On Entry C-section Member#: *State: *Zip Animal 3 Rush registration *Name: ET Not ET %Belgian: *DOB: Birth Weight: Color: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 (for color definitions see below) Sex: Bull Cow Twin: Yes No (please circle one) *RE Tattoo: *LE Tattoo: Calving Ease: Horned: Horned Polled Scurred Blood Case#: Yes No (additional fee below) Natural Steer *DNA Kit: Yes No Some assistance Lab Name: ImmGen Mechanical assistance Canadian Sire Name/Breed: Reg #: Belgian %Belgian Circle One: ABBB BBBI Canadian Belgian No Registration# Dam Name/Breed: Reg #: Transfer On Entry C-section %Belgian Circle One: ABBB BBBI Canadian Belgian No Registration# Name: Address: Member#: *City: *State: *Zip I hereby certify that this is a true and correct statement, and I desire to have same recorded in the ABBB Herdbook. In consideration of which I agree to abide and be bound by the Articles of Incorporation, Bylaws, Rules and Regulations of the Association and amendments thereto. This performance information may be used for ABBB breed improvement programs. Signed: Date: Please choose your payment method (highlight or underline): Color Codes 1=Black 2=Black Roan 3=Black/White 4=Black/White Face ET = Embryo Transfer 5=Blue 6=Blue Roan 7=Blue/White 8=Brown/White PayPal Check 9=Red 10=Red Roan 11=Red/White 12=Roan 13=White 14=White/Black 15=White/Blue Registration Fees Registration of Fullbloods and Purebreds (for Members, Associate Members fee X2) *DNA Kit are required for Fullbloods and Purebreds – all other percentage is optional Registration of Percentage grading-up (50% to Purebred) Certification of Percentage (up to 50%) Certification of Steers Miscellaneous Fees Duplicate Corrected / Additional Certificates Animal transfer of Ownership Embryo Transfer of Ownership Listing of Foreign Registered Animal in ABBB Herdbook Entering Foreign Bloodtype or DNA Genotype at UC Davis $25.00 $40.00 $15.00 $15.00 $15.00 $10.00 $10.00 $10.00 $10.00 $10.00 Rush Charges for any paper work in addition to regular fees $30.00 Your registration application will be processed and blood kit will be mailed as soon as full payment is received. Fees are subject to error and change without notice. Contact us for details. Please send completed Registration Form and Payment to: American Belgian Blue Breeders, Inc. P.O. Box 633404 Nacogdoches, TX 75963 For more info: Telephone & Fax 936.652.25501 | www.belgianblue.org | info@belgianblue.org