All dogs participating in the Obedience 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 can be uploaded on Youtube, DVD or emailed to the registry.
Applications and any video through any venue 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. Video should
not be longer than 30 minutes.
A Certificate with an accompanying ribbon is issued with each title approved.
CD 1-2-3 can be applied for on one application with highest title being the one exhibited in video.

Please print clearly
Check the title you are applying for see fee schedule and link for requirements for titles at bottom of page: OBEDIENCE TEST REQUIREMENTS
(   )CD 1    (   )CD2    (   )CD3    (   )CC   (   )CCM    (    )TD   (   ) AC   (   )ACE

Breed:                                                                                           Registration#                                                              Date of Birth                M       F

_______________________________________ ___________________________________________________/_______/________ [   ]    [   ]
Tattoo or Microchip# if applicable                                                                                             Name of Dog:

_______________________________________________________ ___________________________________________________________
Owners Name:                                                                                                                      Co Owners Name:

_______________________________________________________ ___________________________________________________________
Address:                                                                                                                                                City                                          State/Country                       Zip Code

_______________________________________________________________________   ___________________________ __________________        ______________                                    
Phone #                                                                                                              Email

:___________________________________________   _______________________________________________________________________

Best time to call_____________________ One of our representatives will call you after the judges view your video
Method Of Payment:    
(   ) Credit Card   (   )PayPal(   )                                         Total Fee: $____________as stated below   

Name on credit card(please print):______________________________________________________________
Credit Card #  
                                                                                               Exp.Date                  cvs code
___________________________________________________________                _____/_____/_____ ____________
Cardholder Signature below authorizes this charge


Fees For Testing are as follows PLEASE see the link or for requirements for each title:



                                                                                                    Please mail video/DVD and payment to:                                  
                                                                                                         DESIGNER BREED REGISTRY
                                                                                                                   PO BOX 7681
                                                                                                            NORTH PORT, FLORIDA 34286

                                                                                                         Copy and paste or print page   
CD 1 - Companion Dog Level 1 - $60.00      
CD 2 - Companion Dog Level 2 - $60.00   
CD 3 - Companion Dog Level 3 - $60.00   
CD 1-3 Companion Dog Levels Combined with video
highest title applied for -$160.00  
A Certificate will be issued for each title 1 rosette for

CC - Canine Citizen - $60.00    
CCM - Canine Citizen of Merit - $60.00    
CC+ CCM + CD1+2 Combined - $220.00  
A Certificate issued for each title 1 rosette for
AC - Agility Dog $60.00
ACE - Agility Dog Excellent $60.00
combined $110.00
Submit video with highest level
applied for. A certificate will be issued
for each title. 1 rosette for combined
TD- Tracking Dog - $65.00
                             OBEDIENCE APPLICATION PRINT FORM