Registration Application

Registration Application for Breeding Certification
Owner Information
Name*

First NameLast Name
Membership Number*
Phone*
Add Country Code if outside US.
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Registration Information
REQUESTED SCPS REGISTRATION NAME (See Rules Below)*
SCPS NAMING CONVENTION: The SCPS requires that your dog's registered name begin with his Breeder's kennel name. If the dog's Owner is also a breeder, it is preferred that the the Owner's kennel name be included in the dog's registered name, but it must not come before the Breeder's kennel name. The purpose of this requirement is to facilitate the ease of pedigree study. Example: Smith Scottish Collies bred a puppy named Joe that was purchased by MacGregor Kennels for breeding. In this example, the registered name would look something like "Smith's Joe of MacGregor Kennels". The Breeder's kennel name is first, and the new Owner's kennel name follows after. If the pup was sold for a purpose other than breeding, the registered name might simply be "Smith's Joe".

FOR DOGS ALREADY ENROLLED IN OTHER REGISTRIES: These dogs will not be required to follow the SCPS Naming Convention. We will not require our Members to manage more than one registered name for the same dog. Going forward, however, that dog's progeny will be required to follow the SCPS Naming Convention.

NOTE: Registered Names Cannot Be Changed Once A Dog Is Entered Into The Registry. Please Choose Carefully And Double-Check Spelling And Format.
Is your dog enrolled in any other Registries?*

YesNo
Please list other Registries in which your dog is enrolled.
My Dog was purchased with Full Registration and/or All Breeding rights to the best of my knowledge.*

YESNO
📷 Upload images of listings in OTHER REGISTRIES here. Images, scans, or screenshots accepted.*

OTHER REGISTRIES

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Pedigree
My dog was acquired without a written pedigree (farm dog, adoption, shelter, rescue, etc); therefore, I am unable to provide this information.*

YesNo
Pedigree Statement: please initial here
Your Dog's Breeder / Kennel Name*
Your Dog's Sire*
Your Dog's Dam*
📷 6-Generation pedigree: Please submit your dog's six-generation pedigree, as completely as possible. You may provide a screenshot, scan, or a link to where your dog's pedigree resides in another registry or official website. If you cannot provide a 6 generation pedigree, you will be required to perform an Embark Genetic test to show your Collie is at least 75% Collie OR your dog who appears to be pure Collie can be allowed to apply as an outcross Farm Collie. *

PEDIGREE

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Terms of Service
Please initial your understanding: To apply for Registration, every SCPS Member must agree to abide by the By-Laws and Code of Ethics of the Scottish Collie Preservation Society. *
Please initial your understanding: All official SCPS Registration Documents will be emailed to the email address used for this application. *
SIGNATURE: I give the SCPS Registrar Department permission to verify any and all documents submitted for this dog. *
SIGNATURE: I give permission to release the information contained herein for use in the SCPS public Registry. All information provided by me is true and correct and I have breeding rights to this dog to the best of my knowledge and understanding.*

Should be Empty:

	Clear	Carrier	Affected	Not Tested
Multi-drug Resistance 1 (MDR1) *
Collie Eye Anomaly (CEA) *
Degenerative Myelopathy (DM)
Progressive Retinal Atrophy (Pra-Rcd2)
Cyclic Neutropenia (CN)
Hyperuricosuria (HUU)
Von Willbrand Disease (VWDII)

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Owner Information

Signalment

Registration Information

Pedigree

Activities & Titles

Health & Genetic Testing

Terms of Service