| Address:
___________________________________________________ |
| City,
State: ____________________ |
Zip Code: ____________________
|
| Phone
No.: ___________________ |
Email: _______________________
|
| Signature
of Owner of Sire: _____________________________________ |
|
LITTER
NUMBER:
|
|
|
(Owner
of Dam at Birth of Litter Fills out this section)
|
| I
certify that I was the owner of the above listed Dam on the date the litter
was born. That the number of the puppies in the litters as shown above are
living, and that this pedigree is to the best of my knowlege and belief
true. |
| Owner
of Dam: ______________________________________________ |
| Address:
___________________________________________________ |
| City,
State: ____________________ |
Zip Code: ____________________
|
| Phone
No.: ___________________ |
Email: _______________________
|
| Signature
of Owner of Dam: _____________________________________ |
| Birthdate
(mo/day/yr):__________________________________________ |
| Males:
_______________________ |
Females: _____________________
|
| Breed of Dog: _______________________________________________ |
|
| Yes,
put my name on the WWKC breeders list! I authorize WWKC to give out my name,
address, and phone number to prospective buyers looking for pups and stud
service in my area. I include $10.00 to cover this service for one year. |
