NRTA Registration Form

ELECTRONIC FORM INCLUDING AOL USERS DOG REGISTRATION Certificate/Pedigree FEES FOR CERTIFICATES AND PEDIGREES
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National Rat Terrier Registry

Dog Information

Date: Breed of Dog:

Name: Date of Birth:

Sire Name: Dam Name:

Registered with? Registration Number

Coat Color: Eye Color:

Nose Color: .

Patterns/Markings:
Enter # choice
1. Tri-Colored
2. Patches of Color
3. Solid
4. White blaze-
collar-boots-chest Size: Enter Type
Toy Tot Under 5lbs
Toy Under 10lbs
Mini 10-18lbs
Standard 18-28lbs
Decker Giant22-40lbs

Breeder: Breeders Kennel Name:

Sex:. Body Type
A-Square or B-Long

Owner: Co Owner:

Microchip/Tattoo: Titles:

Sires Information

Sire's Date of Birth: .

Sire's Father Sire's Mother

Registered with? Registration Number

Coat Color: Eye Color:

Nose Color: .

Patterns / Markings:
Enter # choice
1. Tri-Colored
2. Patches of Color
3. Solid
4. White blaze-
collar-boots-chest Size: Enter Type
Toy Tot Under 5lbs
Toy Under 10lbs
Mini 10-18lbs
Standard 18-28lbs
Decker Giant22-40lbs

Breeder: Breeder Kennel Name:

Sex . Body Type
A-Square or B-Long

Owner: Co Owner:

Tattoo: Titles:

Dams Information

Date of Birth: .

Dams Father: Dams Mother:

Registered With? Registration Number

Coat Color: Eye Color:

Nose Color: .

Patterns / Markings:
Enter # choice
1. Tri-Colored
2. Patches of Color
3. Solid
4. White blaze-
collar-boots-chest Size: Enter Type
Toy Tot Under 5lbs
Toy Under 10lbs
Mini 10-18lbs
Standard 18-28lbs
Decker Giant22-40lbs

Breeder: Breeders Kennel Name:

Sex . Body Type
A-Square or B-Long

Owner: Co Owner:

Tattoo: Titles:

Owners Information

Street Address: .

City: State:

Zip: Phone:

E Mail: Club Affiliation:

Co Owners Information

Street Address: .

City: State:

Zip: Phone:

E Mail: Club Affiliation:

GrandSire-(Dogs Grandfather on Sire's Side)

Date of Birth: .

Grand Sire's Father Name Grand Sire's Mother Name

Registered with? Registration Number

Coat Color: Eye Color:

Nose Color: .

Patterns / Markings:
Enter # choice
1. Tri-Colored
2. Patches of Color
3. Solid
4. White blaze-
collar-boots-chest Size: Enter Type
Toy Tot Under 5lbs
Toy Under 10lbs
Mini 10-18lbs
Standard 18-28lbs
Decker Giant22-40lbs

Breeder: Breeders Kennel Name:

Sex . Body Type
A-Square or B-Long

Owner: Co Owner:

Tattoo: Titles:

GrandDam-(Dogs Grandmother on Sire's Side)

Date of Birth: .

Grand Dam's Father Name Grand Dam's Mother Name

Registered with? Registration Number

Coat Color: Eye Color:

Nose Color: .

Patterns / Markings:
Enter # choice
1. Tri-Colored
2. Patches of Color
3. Solid
4. White blaze-
collar-boots-chest Size: Enter Type
Toy Tot Under 5lbs
Toy Under 10lbs
Mini 10-18lbs
Standard 18-28lbs
Decker Giant22-40lbs

Breeder: Breeders Kennel Name:

Sex . Body Type
A-Square or B-Long

Owner: Co Owner:

Tattoo: Titles:

GrandSire-(Dogs Grandfather on Dam's Side)

Date of Birth: .

Grand Sire's Father Name Grand Sire's Mother Name

Registered with? Registration Number

Coat Color: Eye Color:

Nose Color: .

Patterns / Markings:
Enter # choice
1. Tri-Colored
2. Patches of Color
3. Solid
4. White blaze-
collar-boots-chest Size: Enter Type
Toy Tot Under 5lbs
Toy Under 10lbs
Mini 10-18lbs
Standard18-28lbs
Decker Giant22-40lbs

Breeder: Breeders Kennel Name:

Sex . Body Type
A-Square or B-Long

Owner: Co Owner:

Tattoo: Titles:

GrandDam - Dam's Side

Date of Birth: .

Grand Dam's Father Name Grand Dam's Mother Name

Registered with? Registration Number

Coat Color: Eye Color:

Nose Color: .

Patterns / Markings:
Enter # choice
1. Tri-Colored
2. Patches of Color
3. Solid
4. White blaze-
collar-boots-chest Size: Enter Type
Toy Tot Under 5lbs
Toy Under 10lbs
Mini 10-18lbs
Standard 18-28lbs
Decker Giant22-40lbS

Breeder: Breeders Kennel Name:

Sex . Body Type
A-Square or B-Long

Owner: Co Owner:

Tattoo: Titles:

Additional Pedigree information can be entered in the comments box below.

Type Of Pedigree Requested
A $10.00 for Photo I. D. (new dog)
B $12.00 for Photo I. D. listing sire and dam
C $15.00 for Photo I. D.with 2 Generation Pedigree
D $20.00 Dog/Pup, Sire and Dam Photo Certificate
E $30.00 Dog/Pup, Sire, Dam and Grandparents Photo Pedigree
F $8.00 puppy Certificate(non-photo)
G $10.00 two generations Certificate(non-photo)
H $15.00 three generations Certificate(non-photo)
I $20.00 four generations Certificate(non-photo)
J $30.00 five generations Certificate(non-photo) Enter Type Requested
(enter letter)

MAIL APPROPRIATE FEES PAYABLE TO: NRTR 26 PARK DRIVE ROCKY HILL, CT 06067
Comments:

If you are requesting a Photo Pedigree,
along with this application, send in CLEAR, CLOSEUP
photos of all the dogs that you would like to appear
on the Certificate.

Questions? E-Mail to nrta@cox.net

Dog Information
Date:		Breed of Dog:
Name:		Date of Birth:
Sire Name:		Dam Name:
Registered with?		Registration Number
Coat Color:		Eye Color:
Nose Color:		.
Patterns/Markings: Enter # choice 1. Tri-Colored 2. Patches of Color 3. Solid 4. White blaze- collar-boots-chest		Size: Enter Type Toy Tot Under 5lbs Toy Under 10lbs Mini 10-18lbs Standard 18-28lbs Decker Giant22-40lbs
Breeder:		Breeders Kennel Name:
Sex:.		Body Type A-Square or B-Long
Owner:		Co Owner:
Microchip/Tattoo:		Titles:

Sires Information
Sire's Date of Birth:		.
Sire's Father		Sire's Mother
Registered with?		Registration Number
Coat Color:		Eye Color:
Nose Color:		.
Patterns / Markings: Enter # choice 1. Tri-Colored 2. Patches of Color 3. Solid 4. White blaze- collar-boots-chest		Size: Enter Type Toy Tot Under 5lbs Toy Under 10lbs Mini 10-18lbs Standard 18-28lbs Decker Giant22-40lbs
Breeder:		Breeder Kennel Name:
Sex	.	Body Type A-Square or B-Long
Owner:		Co Owner:
Tattoo:		Titles:

Dams Information
Date of Birth:		.
Dams Father:		Dams Mother:
Registered With?		Registration Number
Coat Color:		Eye Color:
Nose Color:		.
Patterns / Markings: Enter # choice 1. Tri-Colored 2. Patches of Color 3. Solid 4. White blaze- collar-boots-chest		Size: Enter Type Toy Tot Under 5lbs Toy Under 10lbs Mini 10-18lbs Standard 18-28lbs Decker Giant22-40lbs
Breeder:		Breeders Kennel Name:
Sex	.	Body Type A-Square or B-Long
Owner:		Co Owner:
Tattoo:		Titles:

Owners Information
Street Address:		.
City:		State:
Zip:		Phone:
E Mail:		Club Affiliation:

Co Owners Information
Street Address:		.
City:		State:
Zip:		Phone:
E Mail:		Club Affiliation:

GrandSire-(Dogs Grandfather on Sire's Side)
Date of Birth:		.
Grand Sire's Father Name		Grand Sire's Mother Name
Registered with?		Registration Number
Coat Color:		Eye Color:
Nose Color:		.
Patterns / Markings: Enter # choice 1. Tri-Colored 2. Patches of Color 3. Solid 4. White blaze- collar-boots-chest		Size: Enter Type Toy Tot Under 5lbs Toy Under 10lbs Mini 10-18lbs Standard 18-28lbs Decker Giant22-40lbs
Breeder:		Breeders Kennel Name:
Sex	.	Body Type A-Square or B-Long
Owner:		Co Owner:
Tattoo:		Titles:

GrandDam-(Dogs Grandmother on Sire's Side)
Date of Birth:		.
Grand Dam's Father Name		Grand Dam's Mother Name
Registered with?		Registration Number
Coat Color:		Eye Color:
Nose Color:		.
Patterns / Markings: Enter # choice 1. Tri-Colored 2. Patches of Color 3. Solid 4. White blaze- collar-boots-chest		Size: Enter Type Toy Tot Under 5lbs Toy Under 10lbs Mini 10-18lbs Standard 18-28lbs Decker Giant22-40lbs
Breeder:		Breeders Kennel Name:
Sex	.	Body Type A-Square or B-Long
Owner:		Co Owner:
Tattoo:		Titles:

GrandSire-(Dogs Grandfather on Dam's Side)
Date of Birth:		.
Grand Sire's Father Name		Grand Sire's Mother Name
Registered with?		Registration Number
Coat Color:		Eye Color:
Nose Color:		.
Patterns / Markings: Enter # choice 1. Tri-Colored 2. Patches of Color 3. Solid 4. White blaze- collar-boots-chest		Size: Enter Type Toy Tot Under 5lbs Toy Under 10lbs Mini 10-18lbs Standard18-28lbs Decker Giant22-40lbs
Breeder:		Breeders Kennel Name:
Sex	.	Body Type A-Square or B-Long
Owner:		Co Owner:
Tattoo:		Titles:

GrandDam - Dam's Side
Date of Birth:		.
Grand Dam's Father Name		Grand Dam's Mother Name
Registered with?		Registration Number
Coat Color:		Eye Color:
Nose Color:		.
Patterns / Markings: Enter # choice 1. Tri-Colored 2. Patches of Color 3. Solid 4. White blaze- collar-boots-chest		Size: Enter Type Toy Tot Under 5lbs Toy Under 10lbs Mini 10-18lbs Standard 18-28lbs Decker Giant22-40lbS
Breeder:		Breeders Kennel Name:
Sex	.	Body Type A-Square or B-Long
Owner:		Co Owner:
Tattoo:		Titles: