German Coolie Society
and
Registry
IGCS&R Business Office
Ida Parmer
1139 LCR 454
Groesbeck, Texas 76642
(254)562-3078
www.coolieregistry.com
 | Submit transfer fee, this form, and the original Registration Papers | |
| 3 clear photographs (both sides and front) MUST be submitted with | |
| this application of Sire/Dam and ALL puppies | ||
| 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 _________________
| Transfer |
Member |
| Within 6 months of purchase |
$5.00 |
| After 6 months of purchase |
$15.00 |
| If dog was not transferred before being bred |
$30.00 |
| Name of Sire |
Registration No. |
Owner and address of Sire |
| IGCS&R Reg Number |
Name of Puppy |
Date Purchased |
Color/Markings (from Registration papers) |
Name of new owner and membership No. |
Address and Contact info |
co-owner, or lessee of the dam listed on this application on the date of birth of the litter and that this dam was mated only to the sire listed on this
application. Should information in this application prove false, applicant will indemnify and defend IGCS&R and hold it harmless against any resulting
loss. The lineage of your dog can be determined with certainty by DNA testing. I (we) further understand that as an owner of an IGCS&R registered litter, I
(we) agree to abide by the IGCS&R Code of Ethics, Breed Standard, and rules of the Coolie Registry, and disciplinary action, if necessary, as determined by
the IGCS&R.
____________________________________________________________________________________________
Owner of Puppy and Date of Signature