Litter Registration Form

A. REGISTRATION CERTIFICATE: non-photo $10.00 
B. PHOTO ID Certificate: $12.00 for single dog registration 
C. PHOTO ID Certificate: $15.00 listing parents/grandparents 
D. 3 GENERATION Certificate: non-photo $20.00 
E. 4 GENERATION Certificate: non-photo $25.00 
$5.00 for each Supplemental Transfer (needed any time a dog changes owner before it is registered)
NNRBA PUPPY 
REGISTRATION 
APPLICATION

Fill in ALL the Pink fields, then print out one form for each puppy in your litter.
Fill in the Blue section after printing for each individual puppy.
Leave the Green sections blank (to be filled in by new owner)
 
LITTER OWNER ..Litter #

..Puppies Sex

Color

..Circle one below that best describes 
  the base color of this dog. 
..Black                                   Red
..Blue                                      Chocolate 
..Brown (Tan-Sable)                     White
..Lemon                                    Charcoal 
..Apricot                                         Silver
..Black and Tan
 Additional Colors

..
 
 

Patterns/Markings 

















.
Breed .......
Date of Birth ..
Date Issued
Sire
Dam
Breeder
Litter Owner
Address
City
State
Zip

 
 
 
 
 
 
 
 
 
 
 


This section is to be filled in by the Litter Owner after all forms have been printed out. 
One box MUST be checked
I (we) still own this dog, apply to register it and have ownership recorded in my (our) name(s) 
I (we) transferred this dog directly to following person(s) on Date_____________________. 
Signed litter owner________________________________. 
I certify that I am in good standing with the NNRBA 
Type of Registration (check one box)
  Full (If the dog is bred, litter applications will be accepted) 
  Limited ( No Litterapplications will be accepted, should not be bred)
.
YOU MUST REGISTER THE PUP BEFORE THE AGE OF 6 MONTHS
The NNRBA reserves the right to correct or revoke for cause any Registration Certificate issued.
Any misrepresentation on this application is cause for cancellation and may result in loss of all
NNRBA privileges for the individuals who violate the integrity of this application.
.
This section is to be filled in by New Owner after Printing
Puppies New Name
IMPORTANT On your final certificate the Breeders NNRBA Registered Kennel Name will appear along with the name you have chosen.

This section is to be filled in by the New Owner(s)
SEND BOTH PAGES, APPROPRIATE FEE AND A CLEAR PHOTO OF PUPPY (IF REQUESTING A PHOTO REGISTRATION) AT LEAST 3" X 5" SHOWING FULL VIEW, NO POLAROID'S. (All photos become the property of the NNRBA) MAIL TO: 
National New and Rare Breed Association (NNRBA)
41 Bodwell Road
East Hartford, CT 06108
Phone # 860-874-8751
Name of Owner____________________________________Address_____________________________

City_____________________________________________State______________Zip_______________

Phone#________________________________Signature_______________________________________

Name of Co-Owner_________________________________Address_____________________________

City_____________________________________________State______________Zip______________

Phone#________________________________Signature______________________________________