Foreign Registration Fee $10.00(if registered outside of U.S. territory)

Canine Companion Package (A) $29.99 Canine Protection Package (B) $49.99 Canine Development Package (C) $69.99

Standard Registration (CKC certificate) $15.00 Photo Registration (CKC Certificate & Photo ID) $25.00

(2 3 generation) $10.00(4 5 generation) $20.00

Please, select a tag color using check boxes in product section on right.

PAYMENT TYPE: CHECK MONEY ORDER AMEX VISA MASTERCARD DISCOVER

CARDHOLDER SIGNATURE

FOR UPDATED PRICES, OFFERS, AND GREAT ONLINE SERVICES GO TO WWW.CKCUSA.COM!Send this form with a Check, MO or Credit Card info to: CONTINENTAL KENNEL CLUB, Inc., P.O. BOX 1628 - WALKER, LA 70785

CANINE CARE PRODUCTS TESTED AND APPROVED BY CKC DOG OWNERSREGISTRATION SERVICES

INSTRUCTIONS: When transferring this dog to a new owner, record the date, sign on the Current Owner’s Signature line, and enter your phone number. Record the new owner’s name, address, phone number & have them sign on the New Owner’s Signature line.

This Supplemental Transfer Form must be submitted along with the original CKC Registration Certificate or with a completed Certification of Ownership form. Each individual must be listed on the form. Only the last individual (new/final owner) who registers the dog pays the transfer fee.

MUST CHOOSE ONE OF FIRST FIVE OPTIONS

$34.95

$6.95

$9.95$12.95

$35.00$11.95

CKC Dog Tag Blk Pink Blue Grn Prp CKC Logo Dog Leash (6’) Adjustable CKC Snap Collar (12” - 19”)

The Super Simple Guide to Hou setr aining Buddy-ID Mini Microchip Kit by Microchip ID Systems Dog Clicker Training Kit Plus by Karen PryorThe How of Bow Wow Training DVDDog Training in 10 Minutes a Day $19.95

$35.00

CARD NUMBER

EX. DATE (MM/YY) EDOC PIZ GNILLIB

I, the undersigned, do hereby agree to abide by all current rules and regulations as set forth by Continental Kennel Club.

PREFERRED BREEDER - Check to prohibit name change.SUPPLEMENTAL TRANSFER FORM NEW OWNER - PRINT the dog’s name in the boxes below.

I, the present owner, transfer this dog on this date __________ directly to:

______________________________________________________________________________CURRENT OWNER (PLEASE PRINT)

______________________________________________________________________________ADDRESS

______________________________________________________________________________CITY / STATE / ZIP / COUNTRY

_____________________________________________________ _____________________CURRENT OWNER’S SIGNATURE PHONE #

______________________________________________________________________________CKC NUMBER (IF AVAILABLE)

______________________________________________________________________________NEW OWNER (PLEASE PRINT)

______________________________________________________________________________ADDRESS

______________________________________________________________________________CITY / STATE / ZIP / COUNTRY

_____________________________________________________ _____________________NEW OWNER’S SIGNATURE PHONE #

By signing this form, I do hereby certify that the information on this dog as listed on this Supplemental Transfer Form is accurate and true. I understand that this form and all other documentation submitted along with this form becomes the property of CONTINENTAL KENNEL CLUB upon receipt. I agree to abide by all current CKC rules,

regulations, and guidelines. Not transferable to an owner with a Canadian address.

ATTENTION! This Supplemental Transfer Form must be used by the original owner to transfer a dog where the original certificate is lost. ATTENTION!