Litter Registration Application

Puppy Registraion Papers mailed to you within 24 hours

Please fill in the boxes below

if you are missing information leave it blank unless the field says required

If you are registering the sire (father) and/or dam (mother) at the same time as this litter enter PENDING in the sire & dam number fields

If you having a problem with this form or have questions E-mail Us or call live line support at 516 942-4395

IMPORTANT READ THE CLASSIFICATION & REGISTRATION INFORMATION PAGES BEFORE FILLING OUT THIS FORM

ARE THE PARENTS OF THIS LITTER REGISTERED? CHOOSE YES OR NOrequired

ARE THE PARENTS OF THIS LITTER BEING REGISTERED ON LINE AT THIS TIME? CHOOSE YES OR NOrequired

IF THE ANSWER TO BOTH QUESTIONS ABOVE WAS NO PLEASE (CLICK HERE) TO REGISTER PARENTS

If you have not registered the sire and/or dam please do so before filling out this form (CLICK HERE) then come back here and fill out this form

If you are registering the sire (father) and/or dam (mother) on the web at this time and this litter enter PENDING in the sire & dam number fields.

If they are already registered put their DRA numbers in the sire and dam # fields

YOUR EMAIL ADDRESS: required

Litter Owner: required

Breed: required

# of Males in this litter: required

# of Females in this litter: required

Date Of Birth: use this format (mm/dd/yyyy: example 12/12/2010) required A value is required.Invalid format Use mm/dd/yyyy

Sire (father) Name: required

Sire Registration No. required

Dam: (mother): required

Dam Registration No. required

Sire (father) Information:

Owner of sire first name:

Owner of sire last name:

Owner of sire Address:

Owner of sire City :

Owner of sire State:

Owner of sire Zip:

Owner of sire Area Code:

Owner of sire Phone No

Dam (mother) Information:

Owner of dam First name: required

Owner of dam Last name: required

Owner of dam Address: required

Owner of dam City : required

Owner of dam State: required

Owner of dam Zip: required

Owner of dam Area Code: required

Owner of dam Phone No : required

For Security Purposes Re-Enter Your E-Mail: required

Place my Paid Litter Listing on the DRA web page required

Please select an item.

If you have more litters to register submit this form and come back to this page and start again

ARE THE PARENTS OF THIS LITTER REGISTERED? CHOOSE YES OR NOrequired ARE THE PARENTS OF THIS LITTER BEING REGISTERED ON LINE AT THIS TIME? CHOOSE YES OR NOrequired IF THE ANSWER TO BOTH QUESTIONS ABOVE WAS NO PLEASE (CLICK HERE) TO REGISTER PARENTS	If you have not registered the sire and/or dam please do so before filling out this form (CLICK HERE) then come back here and fill out this form If you are registering the sire (father) and/or dam (mother) on the web at this time and this litter enter PENDING in the sire & dam number fields. If they are already registered put their DRA numbers in the sire and dam # fields
YOUR EMAIL ADDRESS: required
Litter Owner: required
Breed: required
# of Males in this litter: required
# of Females in this litter: required
Date Of Birth: use this format (mm/dd/yyyy: example 12/12/2010) required	A value is required.Invalid format Use mm/dd/yyyy
Sire (father) Name: required
Sire Registration No. required
Dam: (mother): required
Dam Registration No. required
Sire (father) Information:
Owner of sire first name:
Owner of sire last name:
Owner of sire Address:
Owner of sire City :
Owner of sire State:
Owner of sire Zip:
Owner of sire Area Code:
Owner of sire Phone No

Owner of dam First name: required
Owner of dam Last name: required
Owner of dam Address: required
Owner of dam City : required
Owner of dam State: required
Owner of dam Zip: required
Owner of dam Area Code: required
Owner of dam Phone No : required
For Security Purposes Re-Enter Your E-Mail: required
Place my Paid Litter Listing on the DRA web page required	Please select an item.