WORLD KENNEL CLUB®

REGISTRATION APPLICATION

(512) 772-2490

W.K.C. PO BOX 803 Smithville, TX 78957

Your Email Address:

Breeders Program Registration Fee: $25.00

People interested in the welfare and breeding of purebred dogs founded the World Kennel Club®. There are thousands of purebred dog owners participating in the WKC® program. WKC® keeps up-to-date studbooks and a list of Breeders for the convenience of our members. This list is available for those who want to breed their dogs with another or someone wanting a new puppy for their family. Registration as a breeder with the WKC® does require that you agree to continue to breed pure when breeding.

If you wish to participate in our Breeders Program, please complete this form with payment. This Registered Breeder’s Certificate will be good for 2 years. When issued a Breeder's Certificate you will be added to our Breeder's List, which is furnished to our members upon request.

WKC registered dogs name:

WKC registered dogs number, issued by WKC:

Breed:

Length of time breeding:

BREEDER INFORMATION

Breeder’s Info:

Name:

Phone:

Address:

City:

State/Province:

Zip:

Country:

BREEDER AUTHORIZATION & AGREEMENT

(mark the checkbox to confirm)

I, as a registered Breeder with the World Kennel Club® agree to give to each of my customers, Puppy Registration Forms furnished to me by WKC®. I also authorize WKC® to use my name, address, and phone number to anyone interested in the breeding of pure bred dogs.

"Serving Pure-Bred Breeders since 1959"

PAYMENT PROCESSING:

AMOUNT TO PAY:

Credit Card Information:

First Name on Card*

Last Name on Card*

Card Type*

Card Number*

Card Verification Code*

Expiration Date*

Billing Address:

Address*

City*

State/Province*

ZIP Code*

PHONE Number*

World Kennel Club
Phone: (512) 772-2490
PO BOX 803,
Smithville, TX 78957

THE WORLD KENNEL CLUB® WANTS YOU TO BE PROUD OWNERS OF YOUR PURE-BRED REGISTERED DOG(S)!