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CERTIFICATE/PEDIGREE APPLICATION LONG FORM PRINT - FILL OUT AND SEND TO: NRTA 26 Park Drive Rocky Hill, CT 06067-1717 Phone 860-563-2293 Questions? E-mail nrta@cox.net Registration fees are listed below on the Fee Schedule. No Personal Checks Accepted |
| SECTION A. Description of Dog
Breed of Dog___________________Sex_______Eye color_______________Nose color_____________ Coat color__________________________Date of Birth____________________Weight___________
City_____________________________________________State______________Zip_______________ Email____________________________________________ Phone#________________________________Signature_______________________________________ Name of Co-Owner_________________________________Address_____________________________ City_____________________________________________State______________Zip______________ Phone#________________________________Signature______________________________________
Address_____________________________City_________________State________Zip____________ |
| SECTION D (On Next Page) Pedigree information. In the Coat Color boxes below, write in ALL the colors of your dogs coat and circle the letter that best describes the dogs coat patterns/ markings. Refer to the shaded box in the upper left hand corner of the application for descriptions of patterns/markings. |
| SECTION
D
PATTERNS/MARKINGS (A) solid |
Name of Grand sire | Name of Great Grand sire |
| (B)
patches/spots of color ( piebald)
(C) Tri colored (3 colors on coat) |
Coat Color
Pattern A B C D |
Coat Color
Pattern A B C D |
| (D)
white blaze, collar, boots, chest
(No patches of color) |
Nose Color | |
| Name of Sire | Date of Birth | Name of Great Grandam |
| Coat Color
Pattern A B C D |
Reg# | Coat Color
Pattern A B C D |
| Nose Color | . | |
| Date of Birth | Name of Grandam | Name of Great Grand sire |
| Reg# | Coat Color
Pattern A B C D |
Coat Color
Pattern A B C D |
| Size(Circle One) Toy-Mini-Standard-Decker | Nose Color | |
| . | Date of Birth | Name of Great
Grandam
. |
| Reg# | Coat Color
Pattern A B C D |
|
| . | ||
| Name of Grand sire | Name of Great Grand sire
. |
|
| Coat Color
Pattern A B C D |
Coat Color | |
| . | Nose Color | |
| Name of Dam | Date of Birth | Name of Great Grandam |
| Coat Color
Pattern A B C D |
Reg# | Coat Color
Pattern A B C D |
| Nose Color | . | |
| Date of Birth | Name of Grandam | Name of Great Grand sire |
| Reg# | Coat Color
Pattern A B C D |
Coat Color
Pattern A B C D |
| Size(Circle One) Toy-Mini-Standard-Decker | Nose Color | |
| Date of Birth | Name of Great Grandam | |
| Reg# | Coat Color
Pattern A B C D |
Enter the letter for the type of pedigree/certificate requested from
the Fee Schedule_____.
Please include Money Order or Bank Check No Personal Checks.
Amount enclosed____________.
.
.
FEE SCHEDULE
Copyright © 1996-2003 National Rat Terrier Association (NRTA)