Canadian Kennel Club Application Form printable pdf download

Canadian Kennel Club Application Form

Canadian Kennel Club / Club Canin Canadien

IMPORTANT NOTICE: Canadian law requires that new owners receive their Certificate of Registration within six (6) months of date of sale.

This applications is not a Certificate of Registration and must not be represented as such.

Litter Registration #:

Males:

Females:

Date of Birth:

Sire:

Dam:

Breeder:

Owner at Birth:

For office use only

CMK-620A

A DOG NAME CHOICES

Please complete this form in ink and legible printing.

First Name Choice

Second Name Choice

Third Name Choice

English

French

Indicate if certificate is to be issued in

Colour code

Variety / Coat Classification (if applicable)

Indicate Gender:

Males

Females

I grant permission to use the following reserved kennel name:

Signature of Kennel Name Owner

IDENTIFICATION SECTION

Complete either the microchip section or the tattoo information section.

Tattoo Series

Tattoo Number

and Year Letter

RE = Right Ear

LE = Left Ear

Date dog was implanted:

RF = Right Flank

LF = Left Flank

Tattoo Date:

DOG RECOVERY INFORMATION

Call Name

(

)

Emergency Contact Telephone Number

Emergency Contact Name

For office use only

- Please complete Transfer section on reverse side.

- Owner at birth must side on reverse side.

Canadian Kennel Club Application Form

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