QUEENSLAND INDEPENDENT CAT COUNCIL INC.

(Affiliated with the Australian Cat Federation) http//:

APPLICATION FOR LITTER REGISTRATION

Please tick appropriate box:

LITTER ONLY REGISTRATION (no individual certificates issued). Please complete highlighted columns of form only

** PRICE - $ 10.00 FOR COMPLETE LITTER. Note: ‘Litter only’ kittens can still be individually registered up to the age of 6 months for $5.00 each.

LITTER – ALL KITTENS REGISTERED. If you wish to individually register all kittens complete all sections. Certificates are issued for all kittens.

** PRICE $5.00 PER KITTEN. CERTIFIED PEDIGREES: If you wish to obtain a 4 generation certified pedigree AT TIME OF LITTER REGISTRATION an additional $10.00 per Certificate is required. Overseas pedigrees requiring additional generations please add an ADDITIONAL $15.00 per certificate. NO KITTEN OVER 9 MONTHS OF AGE WILL BE REGISTERED. *If kittens are sold entire, please show registering council and prefix of new owner. Registrations in another person's name, other than the breeder, will not be effected unless a microchip no is stated

BREEDER’S NAME______ADDRESS ______POST CODE: ______PH: ______

e-mail: ______PREFIX: ______BREED: ______DOB: ______NO OF SURVIVING KITTENS: M ______F _____

SIRE:______COLOUR/PATTERN______REG No:______MICROCHIP ______

DAM: ______COLOUR/PATTERN______REG No:______MICROCHIP______

PLEASE ATTACH COPY OF A COUNCIL GENERATED PEDIGREE FOR BOTH THE SIRE & DAM (this is not required where the cat/cats are already registered with QICC)

Name of Kitten (not to exceed 25 characters including prefix and spaces) .
For Litter Only kittens use A-Z (e.g. Kitten A) / Male
Female Neuter
Spay / Coat Colour & Pattern
(including eye colour,where needed & tail length if required) / Registered Owner’s Name
their registering body & prefix if applicable * /

Registered Owner’s Address

(including post code) & phone or e-mail / Microchip Number
Must be shown
If transferring to new owner / Office
use only
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2.
3.
4.
5.
6.

OWNER OF QUEEN TO SIGN: I certify that all of the surviving progeny in the above litter are included in this application. Signed :______Dated:______

Owner of Stud Cat to Sign: I certify that the Dam whose name appears above was served by the Sire whose name appears above on the______(insert date)

OWNER OF STUD TO SIGN:______

Return form to: QICC Inc Registrar - please refer to postal details on web-site under Management Committee/Registrars

Payment Details: Amount Paid $______Paid by EFT / Chq/ Postal Order (please circle)

Preferred payment by Electronic Transfer to Qld Independent Cat council Inc BSB: 633 000 Account: 158907634 Please show your surname and ‘Reg’ as the reference