Multiple Pet Lifetime Enrollment Form - American Kennel Club

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AKC Reunite
8051 Arco Corporate Drive, Suite 200
Raleigh, NC 27617
800-252-7894
FAX 919-816-3828
Multiple Pet Lifetime Enrollment Form - no additonal fees for as long as you own your pet!
3 pet minimum. Please clearly PRINT all information and return to AKC Reunite; attach additional sheets if needed.
Primary Contact Information - include all area codes
First Name _____________________________________
Last Name
______________________________________
Street Address _________________________________
Primary Phone ___________________________________
City __________________________________________
Alternate Phone ___________________________________
State _____________________Zip Code___________
Email Address_____________________________________
Pet Information Pet #1 - $19.95
Microchip ID
_________________________________
AKC Registry # (if applicable)________________________
Pet Name
_________________________________
Please upgrade my pet's ID tag to one of the following:
“I am Loved” Red Aluminum Collar Tag-add $6.95
Species
_________________________________
Breed
_________________________________
“I am Loved” Stainless Steel Collar Tag - add $9.95
Color/ Markings _________________________________
AKC Logo Blue Aluminum Collar Tag-add $6.95
Date of Birth
_______________
Male
Female
AKC Logo Stainless Steel Collar Tag - add $9.95
Spayed / Neutered
Yes
No
Name on CollarTag ___________________________________
Only 12 characters in length
Pet Information Pet #2 - $10.00
Microchip ID
_________________________________
AKC Registry # (if applicable)________________________
Pet Name
_________________________________
Please upgrade my pet's ID tag to one of the following:
Species
_________________________________
“I am Loved” Red Aluminum Collar Tag-add $6.95
Breed
_________________________________
“I am Loved” Stainless Steel Collar Tag - add $9.95
AKC Logo Blue Aluminum Collar Tag-add $6.95
Color/ Markings _________________________________
Date of Birth
_______________
Male
Female
AKC Logo Stainless Steel Collar Tag - add $9.95
Spayed / Neutered
Yes
No
Name on CollarTag ___________________________________
Only 12 characters in length
Pet Information Pet #3 - $10.00
Microchip ID
_________________________________
AKC Registry # (if applicable)________________________
Pet Name
_________________________________
Please upgrade my pet's ID tag to one of the following:
Species
_________________________________
“I am Loved” Red Aluminum Collar Tag-add $6.95
“I am Loved” Stainless Steel Collar Tag - add $9.95
Breed
_________________________________
Color/ Markings _________________________________
AKC Logo Blue Aluminum Collar Tag-add $6.95
Date of Birth
_______________
Male
Female
AKC Logo Stainless Steel Collar Tag - add $9.95
Spayed / Neutered
Yes
No
Name on CollarTag ___________________________________
Only 12 characters in length
Pet Information Pet #4 - $10.00
Microchip ID
_________________________________
AKC Registry # (if applicable)________________________
Pet Name
_________________________________
Please upgrade my pet's ID tag to one of the following:
Species
_________________________________
“I am Loved” Red Aluminum Collar Tag-add $6.95
Breed
_________________________________
“I am Loved” Stainless Steel Collar Tag - add $9.95
AKC Logo Blue Aluminum Collar Tag-add $6.95
Color/ Markings _________________________________
Date of Birth
_______________
Male
Female
AKC Logo Stainless Steel Collar Tag - add $9.95
Spayed / Neutered
Yes
No
Name on CollarTag ___________________________________
Only 12 characters in length
Provide your credit card payment information below
Visa
MasterCard
American Express
Discover
Account Number _______________________________
Expiration Date __________________________________
Signature
________________________________
Name of Cardholder_______________________________
Attach another sheet if necessary. Additional pets are $10 each. All pets must have the same Contacts at time of enrollment; additional
Alternate contacts may be added after enrollment at Changing the Primary Contact is a Transfer, which requires an
additional fee. Prices subject to change. Enrollment in AKC Reunite will help to ensure the safe return of your pet when found, but does not
signfiy ownership.

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