IPDBA - Litter Registration Form

International Progressive Dog Breeders' Alliance
Litter Registration

*Date of Breeding_______/_______/______*		*Date of Birth________/________/_______*

*Breed______________________________*		*Breed______________________________*

*Sire _______________________________*		*Dam_______________________________*

*Reg.#______________________________*		*Reg.#______________________________*

*Owner’s Signature__________________________*		*Owner’s Signature__________________________*

*Address____________________________*		*Address____________________________*

*City______________State_____Zip_____*		*City______________State_____Zip_____*

*Phone_____________________________*		*Phone_____________________________*

*IPDBA Kennel Name ________________*		*IPDBA Kennel Number_______________*

*COLORSEX*		*COLORSEX*

*1._____________________ _______*		*6._____________________ _______*

*2._____________________ _______*		*7._____________________ _______*

*3._____________________ _______*		*8._____________________ _______*

*4._____________________ _______*		*9._____________________ _______*

5._____________________ _______		*10.____________________ _______*

Submit this form completed with $10.00 to the registry office below. The owner of the dam will receive a blue puppy registration for each puppy in the litter. Blue puppy papers must be kept or transferred and later submitted for permanent registration. E-mail

Make checks out to: IPDBA

IPDBA
P.O. Box 311
Upton, KY 42784
Phone (270) 531- 3662

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