BRC GLOBAL LITTER REGISTRATION
DAM OWNER NAME
*
First Name
Last Name
DAM CO-OWNER NAME
First Name
Last Name
DAM OWNER ADDRESS
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
DAM OWNER PHONE
*
-
Area Code
Phone Number
DAM OWNER EMAIL
*
example@example.com
DAM OWNER SIGNATURE
*
CO-OWNER SIGNATURE
LITTER BIRTH DATE
*
-
Month
-
Day
Year
Date
BREED
*
AMERICAN BULLY
XL BULLY
EXOTIC BULLY
FRENCH BULLDOG
ENGLISH BULLDOG
SHORTY BULL
OLDE
BULL TERRIER
APBT
AMERICAN BULLDOG
CHINESE CHONGQING
NUMBER OF MALE PUPPIES
*
NUMBER OF FEMALE PUPPIES
*
DAM REGISTERED NAME
*
DAM BRC GLOBAL NUMBER
*
PLEASE UPLOAD THE DAM'S PEDIGREE IF YOU DO NOT HAVE A GLOBAL NUMBER
Browse Files
THIS IS FOR DOGS WITH ORIGINAL BRC PAPERWORK
Cancel
of
SIRE REGISTERED NAME
*
SIRE BRC GLOBAL NUMBER
*
PLEASE UPLOAD THE SIRE'S PEDIGREE IF YOU DO NOT HAVE A GLOBAL NUMBER
Browse Files
THIS IS FOR DOGS WITH ORIGINAL BRC PAPERWORK
Cancel
of
SIRE OWNER'S NAME
*
First Name
Last Name
SIRE CO-OWNER'S NAME
First Name
Last Name
SIRE OWNER PHONE NUMBER
*
-
Area Code
Phone Number
SIRE OWNER EMAIL
*
example@example.com
SIRE OWNER ADDRESS
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
SIRE OWNER SIGNATURE
*
SIRE CO-OWNER SIGNATURE
FEE
*
$30 (UNDER 6 MONTHS)
$35 (OVER 6 MONTHS)
QUESTIONS/COMMENTS:
PAYPAL PAYMENT SENT TO BRCGLOBALREGISTRY@YAHOO.COM
*
YES - PAYMENT MUST BE SENT OUTSIDE OF THE FORM
NO, I PAID ANOTHER WAY - PLEASE COMMENT BELOW
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