Language
English (US)
IWC Individual Dog Registration Application
Date
*
-
Month
-
Day
Year
Must use mm-dd-yyyy format, or use calendar icon to choose date
Owner Name
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Country
Best Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Registered Name
*
Call Name
Breeder
Birthdate
*
-
Month
-
Day
Year
Date
Variety
*
Longhair
Smooth
Gender
*
Male
Female
Color
*
Markings
DN Number
Microchip Number
(if any)
MDR1
*
N/N (+/+) (A)
N/M (+/-) (B)
M/M (-/-) (C)
CEA
*
N/N (+/+) (A)
N/M (+/-) (B)
M/M (-/-) (C)
FGF5 Coat Length (must be submitted if either parent is a smooth Windsprite)
N/N (+/+) (A)
N/M (+/-) (B)
M/M (-/-) (C)
N/A
Sire's Registered Name
Sire's Registration Number
Sire's DN Number
Dam's Registered Name
Dam's Registration Number
Dam's DN Number
Please send copies of MDR1 & CEA Lab Reports
If BOTH parents are N/N (+/+ or A) for MDR1 and/or CEA, send the PARENTS lab reports unless already on file with Registrar.
If one or both parents are smooth coated Windsprites, send copies of the FGF5 coat length test results.
Send all lab reports and any questions to
Treasurer4IWC@gmail.com
Fees
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( X )
Registration with Registration Certificate
$
15.00
Add Certified Pedigree (optional)
$
5.00
International Postage (if outside USA)
$
5.00
Total
$
0.00
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