Online Single Dog Registration – United Canine Association

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Home
About Us
Recognized Breeds
Registration
Registered Kennels
Breeder Ads
Advertise
- Advertise Your Litter
- Advertise Your Stud
Contact

United Canine Association

Online Single Dog Registration Application

Breed of Dog:

Name of Dog to be Registered: *

Please limit name to 25 characters.

Bloodline (if desired):

Date of Birth: *

Sex: *

Male
Female

Color / Markings: *

Microchip Number / Tattoo:

Pedigree Information:

Required to complete the registration process.

Name of Sire (Father):

Sire's UCA Reg. Number:

Breed of Sire:

Name of Dam (Mother):

Dam's UCA Reg. Number:

Breed of Dam:

Copy of Pedigree:

All Single Dog Applications must be accompanied by at least 3 generations of pedigree information.

Breeder's Information:

Name of Breeder:

First

Last

Breeder's Phone Number:

Breeder's Address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Owner's Information:

Name of Owner: *

First

Last

Name of Co-Owner: (optional)

First

Last

Co-Owner - Type of ownership (optional)

And
Or

Please select one of the following: "and" requires both owner's signatures, "or" requires either signature.

Owner's Phone Number: *

Co-Owner's Phone Number:

Owner's Email:

Email

Confirm Email

Owner's Address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Photos:

3 photos (2 profile shots & 1 frontal head shot) must accompany this application.

#1 Photo - Front: *

#2 Photo - Left: *

#3 Photo - Right: *

#4 Photo - Optional:

Comments

Registration Options:

Registration Choices:

New UCA Registration - Includes Certified Registration Certificate.....$25
New UCA Registration with Photo - Includes Certified Registration Certificate with photo......$40
Laminate UCA Registration Certificate (plus registration fee)......$8

Pedigree Choices:

3 Generation Pedigree....$25
4 Generation Pedigree....$35
5 Generation Pedigree....$45
3 Generation Pedigree w/ Photo Insert (please provide photo)......$35
4 Generation Pedigree w/ Photo Insert (please provide photo)......$45
5 Generation Pedigree w/ Photo Insert (please provide photo)......$55
Laminate Pedigree (plus pedigree fee)......$8

Additional Choices:

UCA Auto Window Decal......$8
Pet Photo Identification Card (laminated)......$10

Processing and Mailing Options:

Standard Processing......$0
RUSH Processing - (5 business days)......$10
SUPER RUSH Processing (3 business days)......$15
Standard Mailing......$0
Outside of the USA Mailing (Canada, Mexico, etc)......$5
Overseas Mailing......$8

Total

$ 0.00

Debit / Credit Card For Payment

Select Type of Card

Name on the Debit / Credit Card: *

First

Last

Credit Card Number: *

Expiration Date: *

Card Verification Code (CVC): *

3 digits on the back of the card

I do hereby certify that I am the true owner of the dog described above and that all of the information provided by me on this application is correct to the best of my knowledge and belief.

Please Sign Above.

Phone

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