Litter Registration Form

Membership must be paid in full before membership submission is completed.

Breeder Name:

Kennel/Farm Name:

Address:

Email:

Primary Phone:

Secondary Phone:

City:

State:

Zip Code:

Sire Name:

Sire AKDA Number:

Dam Name:

Dam AKDA Number:

Litter DOB:

Additional Notes:

List the AKDA number(s) of your karakachan(s):

Microchipping is required. All dogs and litters submitted for registration must be microchipped with numbers included on the appropriate registration forms.

Sex M/F	Microchip Number	Predominant Color(s)	Tail Length (stub/half/long)	Puppy's Name	New Owner's Name	New Owner's Address	New Owner's City	New Owner's State	New Owner's Zip