Litter Information

Litter Date of Birth * +

# of Males *

# of Females *

Dam Information

Dam's MSCA Registered Name *

Dam's MSCA Registration # *

Dam's Microchip/Tattoo # *

Dam Owner's First Name *

Dam Owner's Last Name *

Dam Owner's Street Address *

City *

State/Province/Region *

Zip/Postal Code *

Dam Owner's Phone Number *

Dam Owner's Email Address *

Sire Information

When using the ONLINE Litter Registration Application Form

the MSCA will contact the Owner of the Sire (if different from the Owner of the Dam)

to verify information.

Sire's MSCA Registered Name *

Sire's MSCA Registration # *

Sire's Microchip/Tattoo # *

Sire Owner's First Name *

Sire Owner's Last Name *

Sire Owner's Address *

City *

State/Province/Region *

Zip/Postal Code *

Sire Owner's Phone Number *

Sire Owner's Email Address *

Order Information

Would you like your LITTER REGISTRATION PACKET returned via (select one). *

PAPER MAIL

Online Form Fee *

MEMBER ($12.00)

NON-MEMBER ($27.00)

Late Fee for Litter Registration AFTER 1 year from Litter Date of Birth are double the original fee; additional $100 penalty and petition of the Board of Directors to register your litter AFTER 3 years from Litter Date of Birth.

Must submit paper form for late liter registration.

I certify the above information is true and correct to the best of my knowledge.
Any false or misleading information may lead to the termination of membership rights. *

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