German Coolie Society
and
Registry
APPLICATION
IGCS&R Business Office
Ida Parmer
1139 LCR 454
Groesbeck, Texas 76642
(254)562-3078
www.coolieregistry.com
 | Submit this form together with the appropriate fee to receive an Individual Dog | |
| Registration Paper | ||
| 3 clear photographs (both sides and front) MUST be submitted with this | |
| application of the dog to be registered | ||
| Copy of Sire and Dam's pedigree MUST accompany this form, along with any | |
| information of past lineage (breeder/owner name, color and description of dog) | ||
| Owner MUST be a member of the Society to register a dog with IGCS&R | |
| If dog/bitch has produced 7 or more litters that dog/bitch MUST be DNA | |
| Profiled, if any future litters are to registered | ||
| Make Checks or Money Order payable to IGCS&R, or email for information as | |
| to how to send payment by paypal |
Paid No. ______________
Date _________________
Reg No. ______________
Date _________________
| Individual Dog Registration |
Member |
| Before Offspring produced or sired |
$10.00 |
| After Offspring produced or sired |
$15.00 |
| Name of Dog |
Registration Entity/Number (If known) |
Date of Birth |
| Color and Markings |
Eye Color - Left - Right |
Ear Set Bent Dropped Pricked Tipped |
| Name of Current Owner |
Address/Contact information of Current Owner |
Date Purchased/Adopted |
| Sired / Whelped Litters - Y or N |
Working Ability - Y or N Loose Eyed - Y or N Medium Eyed - Y or N Strong Eyed - Y or N Head or Heel or Both (circle one) |
Work Breed of Livestock Does Dog Work? |
| Name of Breeder/Previous Owner |
Address/Contact Information |
Is Dog to be Used For Breeding Purposes - Y or N |
| Is Dog/Bitch spayed/neutered? |
Please provide any information you deem important about this dog and why he/she should be registered as a German Coolie: |