Member Club

NBC

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EBC

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BCSA

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CSABC

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PLEASE COMPLETE ALL SECTIONS IN FULL

Please type all particulars or print in block capitals and black ink Send the completed form to your club secretary:

www.fbcsa.net

FEDERATION OF BOXER CLUBS OF SOUTHERN AFRICA

MEMBER OF ATIBOX AND THE S A STUD BOOK & LIVESTOCK IMPROVEMENT ASSOCIATION

APPLICATION FOR REGISTRATION OF LITTER IN STUD BOOK REGISTER

BREEDER INFORMATION:

Breeder:
Postal address:
Telephone no.: E-mail address:
Kennel prefix: SA Stud Book Registration Number:

PARTICULARS OF LITTER:

Date of birth: / Photographs of puppies included:
Stud certificate no.: / Litter data no.:
Sire: Name: ______
Registration no.:______
Owner & postal address:______
______
Vet certificate attached?: Recommended to submit Annually ______/ Dam: Name: ______
Registration no.:______
Owner & postal address:______
______
Vet certificate attached?: Recommended to be done Annually ______

NB: If parents are not registered in FBCSA Stud Book Register: Please attach copies of original registration certificates & pedigrees in the New Owner’s Name

Puppy details: (MARKINGS: Flashy = white blaze, white on chest & neck, socks; Medium = white blaze, chest, socks (no white on neck); Minimal = chest, feet, very narrow line or no white on face)

NAME OF PUPPY / COLOUR / MARKINGS
(Please see above for definitions) / SEX / Crypt
%
Please Indicate / MICROCHIP NUMBER / OFFICE USE
REG NO.
fawn / Flashy white markings
brindle / medium white markings
white / minimal white markings
fawn / flashy white markings
brindle / medium white markings
white / minimal white markings
fawn / flashy white markings
brindle / medium white markings
white / minimal white markings
fawn / flashy white markings
brindle / medium white markings
white / minimal white markings
fawn / flashy white markings
brindle / medium white markings
white / minimal white markings

TO BE COMPLETED BY THE BREEDER IN FULL

PUPPY NAME / NEW OWNER DETAILS
TITLE:
SURNAME:
INTITIALS: / E-MAIL ADDRESS:
CONTACT NUMBER: Cell
Home:
POSTAL ADDRESS:
CODE: / RESIDENTIAL ADDRESS:
CODE:
NOTES:
PUPPY NAME / NEW OWNER DETAILS
TITLE:
SURNAME:
INTITIALS: / E-MAIL ADDRESS:
CONTACT NUMBER: Cell
Home:
POSTAL ADDRESS:
CODE: / RESIDENTIAL ADDRESS:
CODE:
NOTES:
PUPPY NAME / NEW OWNER DETAILS
TITLE:
SURNAME:
INTITIALS: / E-MAIL ADDRESS:
CONTACT NUMBER: Cell
Home:
POSTAL ADDRESS:
CODE: / RESIDENTIAL ADDRESS:
CODE:
NOTES:
PUPPY NAME / NEW OWNER DETAILS
TITLE:
SURNAME:
INTITIALS: / E-MAIL ADDRESS:
CONTACT NUMBER: Cell
Home:
POSTAL ADDRESS:
CODE: / RESIDENTIAL ADDRESS:
CODE:
NOTES:
PUPPY NAME / NEW OWNER DETAILS
TITLE:
SURNAME:
INTITIALS: / E-MAIL ADDRESS:
CONTACT NUMBER: Cell
Home:
POSTAL ADDRESS:
CODE: / RESIDENTIAL ADDRESS:
CODE:
NOTES: