BRC GLOBAL SINGLE DOG REGISTRATION
OWNER'S NAME
*
First Name
Last Name
OWNER'S ADDRESS
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
CO-OWNER'S NAME
First Name
Last Name
BREED OF DOG
*
AMERICAN BULLY
XL BULLY (9 MONTHS AND UP)
EXOTIC BULLY
FRENCH BULLDOG
SHORTY BULL
ENGLISH BULLDOG
OLDE
BULL TERRIER
APBT
AMERICAN BULLDOG
CHINESE CHONGQING
OWNER'S PHONE NUMBER
*
-
Area Code
Phone Number
OWNER'S EMAIL
*
example@example.com
DOG'S DESIRED REGISTERED NAME
*
AS IT WILL APPEAR ON THE PEDIGREE
DOG'S BIRTHDATE
-
Month
-
Day
Year
Date
DOG'S GENDER
*
FEMALE
MALE
DOG'S COLOR
*
UPLOAD A PHOTO OF THE DOG
*
Browse Files
Cancel
of
DOG'S CURRENT REGISTRATION - PLEASE CHECK WITH A REP BEFORE SUBMITTING "OTHER" OPTION
*
UKC
ABKC
USBR
AKC
BBC - REQUIRED FOR SHORTY BULL
BBCR
NKC - AMERICAN BULLDOG
ABR - AMERICAN BULLYS ONLY
ADBA
UPLOAD CURRENT REGISTRATION (FRONT OF PED)
Browse Files
OR REGISTRATION CERTIFICATE FOR AKC
Cancel
of
UPLOAD FULL PEDIGREE (INSIDE OF PED)
*
Browse Files
Cancel
of
FEE
*
$30
PAYMENT (MUST BE MADE OUTSIDE OF FORM)
*
I SENT PAYPAL PAYMENT TO BRCGLOBALREGISTRY@YAHOO.COM
I PAID ANOTHER WAY - PLEASE COMMENT BELOW
COMMENTS/QUESTIONS:
Submit
Should be Empty: