Members New Puppy or Collie Transfer
Name
*
First Name
Last Name
SCPS Membership Number
*
SCPS Membership ID Required
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Your Email Address
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Sire Name:
*
Dam Name:
*
Dog Registration Number
*
Date of Sale
*
-
Month
-
Day
Year
Date
Dog Name
*
Date of Birth
*
-
Month
-
Day
Year
Date
Puppy Transfer ONLY - Name change Request
New Name Requested - (Must be approved by Breeder)
Gender
*
Previous Owner Name:
*
First Name
Last Name
Breeder Name:
*
First Name
Last Name
COLOR OF PUPPY
*
Sable and White
Tri-Factored Sable and White
Pure for Sable
Sable Merle
Tri-Factored Sable Merle
Pure for Sable Merle
Blue Merle
Tri Color
Bi-Black
Sable Headed White
Tri-Factored Sable Headed White
Tri Headed White
Blue Merle Headed White
Bi-Blue
Sable Merle Headed White
Tri-Factored Sable Merle Headed White
Any Other Questions?
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Collie Transfer Fee (SCPS Members)
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Collie Transfer Fee (Members)
$
9.00
Total
$
0.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Note: All SCPS documents will be emailed to the address included on this form.
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