 |
|
|
I hereby present the following terrier for EJRTCA registration:
TERRIER'S NAME: _________________________________________________________________
BORN: ________________________ SEX: []Male []Female []Spayed/Neutered
HEIGHT: ___________inches. (measure from floor to top of withers)
COAT: []Smooth []Broken []Rough
COAT COLOR: []White/Brown []White/Black []Tri color []Other: _______________________
EJRTCA Litter Registration Number: _________________________________________________
Information on the Sire:
Name: __________________________________________ EJRTCA Reg. # ___________________
Height: __________ inches at withers, Coat []Smooth []Broken []Rough
Coat Color: []White/Brown []White/Black []Tri color []Other:_________________
Owner: __________________________________________________________________________
Address: ________________________________________________________________________
City: ___________________________ State: ______ Zip: ___________ Phone: _______________
Information on the Dam:
Name: __________________________________________ EJRTCA Reg. # ___________________
Height: __________ inches at withers, Coat []Smooth []Broken []Rough
Coat Color: []White/Brown []White/Black []Tri color []Other: _________________________
Owner: __________________________________________________________________________
Address: ________________________________________________________________________
City: _________________________ State: ______ Zip: ___________ Phone: ________________
Terrier owned by...
Name: ___________________________________________________________________________
Address: _________________________________________________________________________
City: ___________________________ State: ______ Zip: ___________ Country:______________
Home Phone: _________________________________ EJRTCA Member #: __________________
Email: ___________________________________________________________________________
Owner's Signature: ____________________________________ Date: ______________________
© English Jack Russell Terrier Club Alliance, Inc.
|
|
