American Canine Hybrid Club
American Canine Hybrid Club
Welcome to the American Canine Hybrid Club!



Online Hybrid Litter Registration

Please fill out the form below and submit it.
Litter Registration is $7.00 plus $1.00 for each puppy - NOTE Price Change as of 01/01/2005!.
Once we process your registration, it will be sent out immediately.

Breed:
Date Of Birth:
Number of Males:
Number of Females:
Total Amount For Registration
(Please Add $7.00 Plus Total # of Puppies):
Sire's ACHClub Name:
Sire's ACHClub Number:
Dam's ACHClub Name:
Dam's ACHClub Number:
Your Name:
Your Street Address:
Your City:
Your State:
Your Zip Code:
Your Phone Number:
Your Fax Number:
Your E-Mail Address:
ACHClub Breeder ID #:
Would You like to add a pedigree?
($7.00 Plus $1.00 per Puppy - Enter Yes or No):
Total Amount For Pedigree
(Please Add $7.00 Plus $1.00 per Puppy):
Do You Agree to all of the ACHClub's Terms and Conditions?
(Enter Yes or No):
Total Amount For This Registration
(Please Add Total Litter Registration Plus Pedigree Total):
Are You Selling direct To The Consumer? If Yes we will include a consumer pamphlet for each puppy (Enter Yes or No):
Your Credit Card Number:
Expiration Date :
Type of Credit Card - Mastercard and Visa ONLY :
Additional Comments:
Do You Also Own The Sire? (Enter Yes or No)
If Yes, skip the Sire Info and submit the registration:
Sire Owner's Name As Listed With ACHClub
Sire Owner's ACHClub Breeder ID #
Sire Owner's Phone Number
Sire Owner's Street Address
Sire Owner's City
Sire Owner's State
Sire Owner's Zipcode
Sire Owner's E-Mail Address



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