LITTER REGISTRATION BICHON BOLOGNESE ASSOCIATION

If dam was leased, or ownership of dam changed while in whelp, complete a transfer of ownership form before registering litter.

Recorded Name of Sire:

Registration Number:

Recorded Name of Dam:

Registration Number:

Section A: OWNER OF THE SIRE ON MATING DATE COMPLETES THE FOLLOWING INFORMATION

Name of Owner of sire:

I certify that the above dam was mated to the above sire. At the time of the mating I was the owner of said sire. The

mating took place in

City

State

Month

Day

Year

If more than on mating took place, use the first date.

I witnessed the breeding

The litter is a result of a

Natural Breeding

Artificial Insemination

yes

Signature of Owner or Co-owner of Sire:

Section B: OWNER OF THE DAM ON DATE OF BIRTH OF LITTER COMPLETES THE FOLLOWING INFORMATION
I hereby apply to register this letter and certify that I was the owner of the above named dam on the date of the birth of the litter and that the dam was not mated to any other dog during her season. I also certify that all representations of this application are true.
I witnessed the mating		yes		no

Owner of Dam:

Address of owner of Dam
	Street		City		State	Zip
Name of Co-Owner of Dam

Signature of Owner or Co-Owner of Dam

If this application is accepted BBA will send the litter owner one application for each dog in the litter.
Any misrepresentation on this application is a cause for cancellation and may result in the loss of club privileges.

CHECK OR MONEY ORDER MUST ACCOMPANY THIS FORM

MAKE CHECKS PAYABLE TO Bichon Bolognese Association of America, Inc.