ARBMR REGISTRATION APPLICATION

AMERICAN RARE BREED MI-KI REGISTRY
SINGLE PUREBRED MI-KI REGISTRATION APPLICATION
PLEASE READ ALL THE INSTRUCTIONS LISTED BELOW BEFORE COMPLETEING
THIS APPLICATION. PRINT ALL INFORMATION (except signature).
USE BLACK INK AND CAPITAL LETTERS WHEN FILLING OUT THIS APPLICATION.
Make all check payable to (ARBMR) Registrar Lawrie Willis

Mail to: AMERICAN RARE BREED MI-KI REGISTRY 209 Lee Ridge Road SE Cleveland, TN 37323

Registered Name of Mi-Ki: ______________________________________________________
The Registration name is to include the Kennel Name of the Mi-Ki breeder.
Sex: ________ Spay/Neuter: ___ Yes ___ No Date Of Birth: ___________________________
Color and Markings: ______________________________________________
(Example: White, Black, and Blue Silver)
Whelping "Birth" Location: City: ________________________ State: ________
UKC DNA #: Z_________ If DNA has been done through another DNA company please fill in the following.
DNA Company: ______________________________ City:______________________ State: _______ DNA #: ____________
Breeder’s Name: ________________________________________
Breeder's Full Mailing Address: _______________________________________________________
Breeder's Phone Number: (_____)______ - ________ Breeder's Email Address: _____________________
IF THE ABOVE MI-KI’S SIRE AND/OR DAM ARE NOT REGISTERED WITH THE ARBMR, IT IS REQUIRED THAT YOU FURNISH A COLOR COPY OF THE DNA CERTIFICATE AND A BLACK AND WHITE COPY OF THE REGISTRATION CERTIFICATE THAT YOU CURRENTLY HAVE FROM OTHER REGISTRY.
Owner's Name: _______________________________________________________
(Example: John and/or Joanna Smith or John Smith)
Owner’s Full Mailing Address: _______________________________________________________
Home Phone: (_____)______ - ________ Best time to call? ___________ Cell Phone: (_____)______ - ________
Email Address: _______________________________________________
Signature(s) as appearing above: ______________________________________________ Date of Signed: _______________

Instructions for Completing ARBMR's Purebred Mi-Ki Registration Application
1. Clearly, print or type ALL INFORMATION . If we cannot read all information requested, the application will be returned to you. This will delay your registration certificate.
2. If the Mi-Ki is or has been registered with another Mi-Ki Organization, Club, or Association, a copy of this Mi-Ki's registration certificate MUST accompany this application.
3. Breedable Mi-Kis: A color copy of the individual Mi-Ki (as appearing above) DNA certificate MUST also accompany this application.
4. Mi-Kis eligible for registration with the ARBMR MUST be registered in owner(s) name as appearing above only.
5. Failure to sign and date this application along with incorrect fee will result in delay of processing registration.
6. If the ARBMR finds, at any time, that the owner misrepresents any information on this registration application, or misrepresents their Mi-Kis or the Mi-Ki breed, this will be considered cause for cancellation and will result in loss of all ARBMR privileges.
7. If you have any questions regarding this registration application, please contact the ARBMR at 423-479-3851 or you can send an e-mail message (please include your phone number) to the ARBMR .

Registration Form (7/7/2007)

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