AMTC SINGLE DOG REGISTRATION

AMTC Single Dog Registration

This application is for the following: American Morkshire Terrier, Yorkshire Terrier, Maltese, Biewer and BIRO breeds.
Name of Dog - limited to 30 characters including spaces and must contain two words*
Dog's Date of Birth*

MonthDayYear
Breed of Dog:*
Gender*

MaleFemale
Color of Dog:*

017 - Blue & Gold018 - Blue & Tan019 - Black & Gold020 - Black & Tan021 - Tan (Gold)022 - White023 - White & Tan024 - Chocolate025 - Chocolate & Tan026 - Chocolate & Gold027 - Black028 - Black & White029 - Combination (3 Colors)
Microchip/Tattoo Number:
List Your Dog's Microchip or Tattoo Number
Photos - Upload Front heat shot (front facing) photo of dog registering.

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If unable to upload photo, photo must be submitted by email to amtcregistry@gmail.com Cancelof
Breeder's Name:
If unknown - state "unknown"
DUAL REGISTERED DOGS - Upload Current Registration Certificate and Pedigree

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Parent(s) of Dog

Sire (Father) and Dam (Mother)
Sire (Father) Name
Breed of Sire
Sire Color/Markings
Is Sire Registered w/another Club/Registry?*

NoYes
Dam (Mother) Name
Breed of Dam
Dam Color/Markings
Is Dam Registered w/another Club/Registry?*

NoYes
Owner Information

About You
Owner's Full Name*

First NameMiddle NameLast Name
Owner's Birthdate*

MonthDayYear
Owner's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Owner's Phone Number*

Area CodePhone Number
Owner's E-mail:*

Confirmation Emailexample@example.com
I do hereby certify that I am the owner of the canine described above and that all of the information provided by me is correct and true. I agree to abide by all AMTC® rules, regulations, and policies; also understand that I am responsible for all information contained herein. All applications and photos become the property of AMTC. AMTC reserves the right to refuse an application as well as correct or revoke any registration at any time.*

I AGREE
Registration Options

Select a registration package
Registrations Options
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Single Registration$25.00
Official Registration Certificate, 30-days of AMTC Pet Insurance, enrollment in Trupanion monthly newsletter.

Single Registration Package$64.99
Official Registration Certificate, Certified Pedigree up to 3 generations, 30-days of AMTC Pet Insurance, AMTC Dog Tag and enrollment in Trupanion monthly newsletter.

Dual Registration$20.00
For the registration of canines having lineage that is not registered with American Morkshire Terrier Club. You must provide copy of your dog's current Registration Certificate and Pedigree if you have.

Single Microchip$24.99
Single Microchip that includes prepaid enrollment form w/implant instructions. Lifetime recovery enrollment.

AMTC Dog Tag$13.99
500 designs available. Design your own pet tag. Offered at discount for AMTC members only!

Welcome Pet Candle$15.99
13oz Pet Candle is the perfect gift for anyone welcoming a new pet or just to enjoy! Surprise Scented Candle.

Priority Mail$9.95
Rush Processing

International/Outside US Mailing$8.95
Mailing for outside the United States or overseas

Subtotal $0.00Tax $0.00Total $0.00
Please verify that you are human*
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AMTC Single Dog Registration

Parent(s) of Dog

Owner Information

Registration Options