Show/Conformation Title Application Designer Breed Registry |
All dogs participating in the Champion Certification program must be registered with the DBR.If your dog is not registered with the
DBR you may submit an individual application for registration with the required fee along with this application.
All video tapes and applications become the property of the Designer Breed Registry Certificate will be
issued within 3 weeks of submission. Once your video has been approved any and or all fees are not refundable. All decisions of
judges are final.
If your video is not approved you will not be charged.
Please print clearly
Check the title you are applying for: ( )CHAMPIONSHIP CERTIFICATE ( )MERIT CHAMPION CERTIFICATE **
Breed:___________________________________________________________Registration #_________________________
Date of Birth________/________ Male( ) Female( ) Neutered( ) Spayed( )
Name of Dog:_________________________________________________________________________________________
Owners Name:_________________________________________________________________________________________
Address:______________________________________________________________________________________________
City:________________________________________________State/Country:_________________Postal/Zip:_____________
One of our representatives will call you after we receive this application to scheduale a time to view your video
Best time to call___________________ Phone #_____________________________________
Method Of Payment: ( ) Credit Card ( ) PayPal Invoice
Fee:Conformation Championship $165.00 Merit Championship Spayed or Neutered Dog $150.00
Name on credit card(please print):______________________________________________________________
Credit Card #___________________________________________________________Exp.Date_____/______
Cardholder authorizes this charge
Card Holders Signature:___________________________________________________Date:____/_____/____
Please mail to: Printable Page or Copy and Paste
Designer Breed Registry
PO BOX 7681
NORTH PORT, FL.34286
Phone 1-732-256-9415
DBR you may submit an individual application for registration with the required fee along with this application.
All video tapes and applications become the property of the Designer Breed Registry Certificate will be
issued within 3 weeks of submission. Once your video has been approved any and or all fees are not refundable. All decisions of
judges are final.
If your video is not approved you will not be charged.
Please print clearly
Check the title you are applying for: ( )CHAMPIONSHIP CERTIFICATE ( )MERIT CHAMPION CERTIFICATE **
Breed:___________________________________________________________Registration #_________________________
Date of Birth________/________ Male( ) Female( ) Neutered( ) Spayed( )
Name of Dog:_________________________________________________________________________________________
Owners Name:_________________________________________________________________________________________
Address:______________________________________________________________________________________________
City:________________________________________________State/Country:_________________Postal/Zip:_____________
One of our representatives will call you after we receive this application to scheduale a time to view your video
Best time to call___________________ Phone #_____________________________________
Method Of Payment: ( ) Credit Card ( ) PayPal Invoice
Fee:Conformation Championship $165.00 Merit Championship Spayed or Neutered Dog $150.00
Name on credit card(please print):______________________________________________________________
Credit Card #___________________________________________________________Exp.Date_____/______
Cardholder authorizes this charge
Card Holders Signature:___________________________________________________Date:____/_____/____
Please mail to: Printable Page or Copy and Paste
Designer Breed Registry
PO BOX 7681
NORTH PORT, FL.34286
Phone 1-732-256-9415
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