APPLICATION FOR & SINGLE REGISTRATION NOTE: When requesting an accelerated serivce, you must write RUSH, Applications are furnished free of charge and can be photocopied as needed. Once submitted, all applications become property of UKC and are not EXPEDITED or NEXT DAY AIR on the outside front of the envelope. returned. UKC reserves the right to refuse an application as well as correct or revoke any registration at any time. UKC reserves the right to change Faxed or emailed applications will be charged an EXPEDITED service any and all rules, fees, etc. without notice. Prices effective July 15, 2013 fee of $35. Incomplete applications may result in processing delays. No PLEASE WRITE CLEARLY. UKC IS NOT RESPONSIBLE FOR ERRORS CAUSED BY ILLEGIBLE HANDWRITING. (Incomplete applications may result in processing delays.) refunds will be issued due to an incomplete application. (Only applicable to registration paperwork, excludes product delivery.) Step 1 Information Breed: Does this dog have a Temporary Listing number? I No I Yes If yes, TL# ______

Color Sex______Date of Birth ______/______/______month day year Tattoo______Microchip ______Is dog spayed/neutered? I No I Yes. If yes, provide date ______/______/______month day year Owner/Registrant(s) of Sire at time of breeding (if available) ______

Owner/Registrant(s) of Dam at time of breeding (if available) ______Dog Name (Dog name must not exceed 30 characters and spaces. Any punctuation is considered a space.) Dog’s name must consist of two words or more. The Sole Signatory’s last name will be added to names containing only one word. United Kennel Club reserves the right to change or deny any name UKC deems to be inappropriate, lewd or offensive.

Must be filled out by the Sole Signatory of this dog. If more than one individual is being listed on the dog’s record, the Sole Signatory Designation Step 2 Sole Signatory Information Form must be completed. This form can be downloaded at www.ukcdogs.com or requested by emailing [email protected]. Print Name of Sole Signatory ______(If more than one individual is being listed on the dog’s record, the Sole Signatory Designation Form must be completed.) Current Mailing Address ______(United Kennel Club is not responsible for undeliverable mail due to incomplete mailing addresses.) City ______State/Province ______Postal Code ______Country ______

Phone (______)______Email Address (Required for Expedited Service.) ______Step 3 Rules & Inspection Option 1) Breed Inspector Section To be completed ONLY by UKC Breed Inspector (Sole Signatory/Registrants: Do not write in this area.) IMPORTANT INFORMATION & RULES Once inspection has been completed, the breed inspector must complete and sign this section. The inspector will then mail the application, Governing Cur/Feist Single Registration fees, and any additional registration documents to UKC. No photos are required by UKC if the dog is Applications are furnished free of charge and can be photocopied as needed. inspected by a breed inspector. Mountain , Mountain Feist, and Stephen’s Curs will be required to show proof of registration from Once submitted, all applications become property of UKC and are not returned. an acknowledged registry to the breed inspector. UKC reserves the right to refuse an application as well as correct or revoke any Inspector’s printed name ______registration at any time. UKC reserves the right to change any and all rules, fees, etc. without notice. Inspector’s address ______City______The rules for Single Registration for the Cur/Feist breeds are as follows: State/Province______Postal Code______Country ______1. Completed UKC Application for Cur/Feist Single Registration is Phone (______)______Email ______required for all breeds . I attest that: 2. Copy of your dog's registration certificate from a UKC acknowledged 1) I am qualified to serve as a UKC Breed Inspector, being a registry if applicable. See breed specific requirements below. K UKC Field Representative K UKC Licensed Hunt Master : Not required K UKC Licensed Cur/Feist Bench Show Judge or K UKC Staff Member; : Original Mountain Cur Breeders Association, 2) I am sufficiently familiar with the UKC breed standard to evaluate the dog whose information is recorded here; Kemmer Stock Breeders Association 3) I have visually inspected this dog and have found it to meet its UKC Breed Standard without exhibiting any disqualifications; Mountain Feist: National Kennel Club 4) I have been presented with the proper documentation signifying this dog is eligible for UKC Registration; and Stephen's Cur: Stephen's Stock Registration 5) I do not own this dog, and did not own its sire or dam at the time of breeding. : Not required Treeing Feist: Not required Inspector’s Signature______Date ______3. A complete three generation pedigree is required for Mountain Curs and Stephen’s Curs only. Option 2) Photo Inspection Section To be completed by the Sole Signatory 4. Three color photographs. One photo of each side of the dog and one 1. Is a complete three-generation pedigree provided? (If applicable) K Yes K No photo of the front must be provided for all breeds. Photos should be 2. Are three color photographs provided? K Yes K No taken at eye level with the dog in a standing position. 3. Is proof of registration with an acknowledged registry attached?(if applicable) K Yes K No 5. Single Registration fee of $20 made payable in US funds to UKC. 4. Mail completed application, fees, photos, and any additional registration documents to the United Kennel Club. Continue to Steps 4-7 g Step 4 You may handwrite your dog’s complete three generation pedigree below or attach a photocopy. Please include any UKC numbers as the pedigree will appear exactly as it is written. Do not include titles or degrees. without a complete three-generation pedigree are eligible for Registration. Unknown ancestors will be indicated as “Open” in the pedigree. Sire ______UKC No. ______

Sire ______UKC No. ______

Dam ______UKC No. ______

Sire ______UKC No. (if available) ______

Sire ______UKC No. ______

Dam ______UKC No. ______

Dam ______UKC No. ______

Sire ______UKC No. ______

Sire ______UKC No. ______

Dam ______UKC No. ______

Dam ______UKC No. (if available) ______

Sire ______UKC No. ______

Dam ______UKC No. ______

Dam ______UKC No. ______

Step 5 Fees (Subject to change without notice) Checks and money orders must be payable in US funds and made to the order of : United Kennel Club • Attn Cur/Feist Single Reg. Dept. • 100 E. Kilgore Rd. • Kalamazoo, MI 49002-5584 K Single Registration Fee ...... $20 each ______Phone: (269) 343-9020 • Fax: (269) 343-7037 • www.ukcdogs.com *K Next Day Air Service ...... $50 Faxed or emailed applications will be charged an Expedited Service fee of $35. (Available for physical mailing addresses in Continental US only / Saturday delivery is not available / Credit Card Information (Major Credit Cards Accepted) No P.O. Box addresses.) UKC Office Use Only K Declined K Approved *K Expedited Service ...... $35 Cardholder’s Name ______(Upon receipt at UKC, processed and returned within five business days, with tracking number. Auth # ______Cardholder’s Signature ______Valid email address must be provided. Available in continental US only.) In Date______Fee ______Check No. ______*K Rush Service ...... $25 Cardholder’s Address ______(Processed within five business days of receipt at UK C/ does not include time in transit.) Init ______Ctrl # ______GRAND TOTAL $______Credit Card Number ______*( UKC is not responsible for undeliverable mail due to Single approved ______incomplete mailing addresses.) Expiration Date ______

Step 6 Is all required documentation attached? (Incomplete applications I Completed and Signed Cur/Feist Single Registration Application (see Step 7) I Three color photographs I Sole Signatory Form (if applicable) may result in I Proof of Registration (if available) I Payment I Three generation pedigree (if available) processing delays) Step 7 By signing this application I agree to abide by all UKC rules, regulations, and policies; including the UKC Breeder Code of Ethics and the Rules and Information Governing Cur/Feist Single Registration. Additionally, I attest that all of the information and facts included on this form are true and correct. I further attest that the dog for which Single Registration is being applied: a) meets the UKC breed standard, as interpret- ed by UKC, for the breed for which it is being registered; b) does not exhibit any of the breed standard disqualifications; and c) is a good specimen of that breed.

Signature of Sole Signatory (Required) ______Please allow 4-6 weeks for processing FO3SQ Rev. 12-15