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.
titles@designerbreedregistry.com
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
___________________________________________________Date:______/_____/______
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
732-256-9415
Copy and paste or print page
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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
combined.
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
combined.
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
combined.
AC - Agility Dog $60.00
ACE - Agility Dog Excellent $60.00
AC + ACE combined $110.00
Submit video with highest level
applied for. A certificate will be issued
for each title. 1 rosette for combined
ACE - Agility Dog Excellent $60.00
AC + ACE 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
DESIGNER BREED REGISTRY
OBEDIENCE APPLICATION PRINT FORM
OBEDIENCE APPLICATION PRINT FORM
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