Akc Canine Partners Special Listing Application
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1AKC CANINE PARTNERS
SPECIAL LISTING APPLICATION
This application is used to apply for a Canine Partners Number for non
AKC registered dogs when ordering a Canine Good Citizen or
Therapy Dog title of record which becomes part of a dog’s official name.
BOTH your title application & Canine Partners Application MUST be sent in together to honor the $19 listing fee.
You are applying for a Canine Partners Number because your dog recently met the requirements for a:
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CGC Title
Therapy Dog Title
Official Dog Name Desired:_________________________________________________________________________
Microchip#: (not required)______________________________________
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Date of Birth:_____/______/________
Male
Female
Date Joined Family:_____/______/________
You can fill in up to two breeds if known: Breed 1:_______________________
Breed 2:______________________
Color:
Markings: (if applicable)
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Black
Yellow
Red
Tri-color
Brindle
Speckled
Merle
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Blue
Gray
Tan
Brown
Spotted
Parti-color
Solid
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Orange
White
Other:____________
OWNER INFORMATION
Owner’s Name:___________________________________________________________________________________
Address:________________________________________________________________________________________
City/State/Zip:____________________________________________________________________________________
Tel 1:__________________________________________ Tel 2:____________________________________________
Email:__________________________________________ Signature:_______________________________________
PAYMENT INFORMATION - $19 Application Fee
Check off type of payment. Checks or Money Orders should be made payable to: The American Kennel Club
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VISA
MC
AMEX
DISC
Check#______
Money Order
Account #:____________________________________________________________ Expiration Date: _____________
Cardholder’s Name:________________________________ Cardholder’s Tel:_________________________________
Please send to: AKC Canine Good Citizen Dept.
PO Box 900064
Raleigh, NC 27675-9064
For Inquiries please contact:
AKC CGC/THD Department- Tel: 919-816-3637 or Email:
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