| Litter Registration |
| Type or write very clearly |
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| Number of Puppies to Register_______________________Date Whelped_____________________________ Breed_____________________________________________________________________________________ Kennel Name_______________________________________________________________________________ Sire:______________________________________________________________________________________ Color:________________________________________Date of Birth_________________________________ Registration Number________________________________________________________________________ Owner of Sire:_________________________________Date of Service_______________________________ Dam:______________________________________________________________________________________ Color:_________________________________________Date of Birth________________________________ Registration Number________________________________________________________________________ Owners Name of Litter at Birth_______________________________________________________________ Address:___________________________________________________________________________________ City:______________________________________________________________________________________ State______________________________________________________Zip_____________________________ E-Mail_____________________________________________________________________________________ Phone_____________________________________________________________________________________ Print and complete form and enclose $10.00 U.S. Funds Postal Money Order Registration to: (Make money order payable to Ray Giacobbe) Ray Giacobbe 1700 Ridgewood Avenue, Suite D Holly HIll, Florida 32117 |