Breeder Name:

Kennel Name (if used):

Address:

City:  State:  Zip:  Country:

Phone:  Email:   Website:

Do you hold a USDA License for resale of dogs?:

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First Dog:

Name:  AKC#:  

Breed:  If Cockapoo what generation:

Sex:  Color:  Weight:  DOB:

Any CERF/OFA/PennHip Info:

Other Kennel Club Registration(eg CKC if applicable):

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Second Dog:

Name:  AKC#:  

Breed:  If Cockapoo  what generation:

Sex:  Color:  Weight:  DOB:

Any CERF/OFA/PennHip Info:

Other Kennel Club Registration( eg CKC if applicable):

=========

Third Dog:

Name:  AKC#:  

Breed:  If Cockapoo what generation:

Sex:  Color:  Weight:  DOB:

Any CERF/OFA/PennHip Info:

Other Kennel Club Registration(eg CKC if applicable):

=========

Fourth Dog:

Name:  AKC#:  

Breed:  If Cockapoo what generation:

Sex:  Color:  Weight:  DOB:

Any CERF/OFA/PennHip Info:

Other Kennel Club Registration(eg CKC if applicable):

==========

If you have more than four dogs to register please return to this form, enter your Breeder name with the word "CONTINUED" (you do not need to complete all the demogprahic info again, and continue to enter your dogs' information. In the Payment Info field again enter "CONTINUED". Repeat using this form this way until you have entered information for all of your kennel stock.

Upon completion and payment of your registration, you will be added to the online listing of NACR breeders on the NACR Website and be entitled to all of ther breeder benefits offered. This listing will include your name/kennel name, city, state, phone and email unless you indicate otherwise. You may also include a small amount of information about your breeding program so please let us know here what you would like:

Payment will be made by (Indicate PayPal or Check/MO):

Notes to the NACR Office:

Click here to send info to