ELECTRONIC FORM
                          DOG REGISTRATION Certificate/Pedigree
FEES FOR CERTIFICATES AND PEDIGREES
If you can't or would rather not fill out the online form please see our print form page.
.
.

National New and Rare Breed Association

Dog Information
Date: Breed of Dog:
Name: Date of Birth:
Sire Name: Dam Name:
Registered with? Registration Number
Coat Color: Eye Color:
Nose Color: .
Patterns/Markings: Size:
Breeder: Breeders Kennel Name:
Sex:. Body Type 
Owner: Co Owner:
Microchip/Tattoo: Titles:

Sires Information
Sire's Date of Birth: .
Sire's Father Sire's Mother
Registered with? Registration Number
Coat Color: Eye Color:
Nose Color: .
Patterns / Markings: Size: 
Breeder: Breeder Kennel Name:
Sex . Body Type 
Owner: Co Owner:
Tattoo: Titles:

Dams Information
Date of Birth: .
Dams Father: Dams Mother:
Registered With? Registration Number
Coat Color: Eye Color:
Nose Color: .
Patterns / Markings: Size: 
Breeder: Breeders Kennel Name:
Sex . Body Type 
Owner: Co Owner:
Tattoo: Titles:

Owners Information
Street Address: .
City: State:
Zip: Phone:
E Mail: Club Affiliation:

Co Owners Information
Street Address: .
City: State:
Zip: Phone:
E Mail: Club Affiliation:

GrandSire-(Dogs Grandfather on Sire's Side)
Date of Birth: .
Grand Sire's Father Name Grand Sire's Mother Name
Registered with? Registration Number
Coat Color: Eye Color:
Nose Color: .
Patterns / Markings: Size: 
Breeder: Breeders Kennel Name:
Sex . Body Type 
Owner: Co Owner:
Tattoo: Titles:

GrandDam-(Dogs Grandmother on Sire's Side)
Date of Birth: .
Grand Dam's Father Name Grand Dam's Mother Name
Registered with? Registration Number
Coat Color: Eye Color:
Nose Color: .
Patterns / Markings: Size:
Breeder: Breeders Kennel Name:
Sex . Body Type 
Owner: Co Owner:
Tattoo: Titles:

 

GrandSire-(Dogs Grandfather on Dam's Side)
Date of Birth: .
Grand Sire's Father Name Grand Dam's Mother Name
Registered with? Registration Number
Coat Color: Eye Color:
Nose Color: .
Patterns / Markings: Size: 
Breeder: Breeders Kennel Name:
Sex . Body Type 
Owner: Co Owner:
Tattoo: Titles:

GrandDam - Dam's Side
Date of Birth: .
Grand Dam's Father Name Grand Dam's Mother Name
Registered with? Registration Number
Coat Color: Eye Color:
Nose Color: .
Patterns / Markings: Size: 
Breeder: Breeders Kennel Name:
Sex . Body Type 
Owner: Co Owner:
Tattoo: Titles:

Additional Pedigree information can be entered in the comments box below.
 
Type Of Pedigree Requested
A  Transfer Registration $2.00 per dog Photo I. D.
B  $10.00 for Photo I. D. (new dog)
C  $12.00 for Photo I. D.with 3 Generation Pedigree 
D  $20.00 Dog/Pup, Sire and Dam Photo Certificate 
E  $30.00 Dog/Pup, Sire, Dam and Grandparents Photo Certificate 
F  $8.00 puppy  Certificate(non-photo)		 Enter Type Requested
(enter letter)
 MAIL APPROPRIATE FEES TO: NNRBA  41 BODWELL RD  EAST HARTFORD, CT 06108-1520
Comments:

If you are requesting a Photo Pedigree,
along with this application, send in CLEAR, CLOSEUP
photos of all the dogs that you would like to appear
on the Certificate.


Questions? E-Mail to nnrba@snet.net