Stud Service Application Form
Apply for stud services with RBKZ Simba at Quantum Bully Kennelz. Please complete all required sections for consideration.
Owner Information
Please provide your contact details.
Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email Address
*
example@example.com
City & State
*
Dam Information
Details about the female dog to be bred.
Dam’s Registered Name
*
Call Name
Registry
Please Select
ABKC
ABR
UKC
Other
Registration Number
*
Age of Female (in years)
*
Has she had previous litters?
Yes
No
If yes, how many previous litters?
Describe temperament
*
Health & Eligibility
Provide health details and eligibility documentation.
Date of last heat cycle
*
-
Month
-
Day
Year
Date
Preferred breeding timeframe
*
Negative Brucellosis test within 30 days?
*
Yes
No
Upload copy of Brucellosis test result
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Upload proof of vaccinations
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Any known genetic issues? If yes, please describe.
*
Breeding Method
Select your preferred breeding method and related information.
Preferred breeding method
Natural Breeding
Artificial Insemination (AI)
Semen Shipping
Will a veterinarian be involved?
Yes
No
Agreement & Confirmation
Please confirm your understanding and agreement.
I have read and agree to the Quantum Bully Kennelz Stud Service Agreement.
*
I have read and agree to the Quantum Bully Kennelz Stud Service Agreement.
My female meets the stated Female Quality Standards.
*
My female meets the stated Female Quality Standards.
I understand that submission of this form does not guarantee approval and that all breedings are subject to acceptance.
*
I understand that submission of this form does not guarantee approval and that all breedings are subject to acceptance.
Additional Notes
Share any additional information or requests.
Additional information or notes
Submit Application
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