Single Dog Registration Application

Register now over the internet only $25.00

Get the Deluxe Certificate with Gold Seal for only $5.00 additional

NEW Lost Pet Recovery Service

CLICK HERE for info This will open a new window so you can come back to this form

Training Manuals!

Latest editions of the best selling Do It Right Series

Do It Right Psychology & Training

Fun with Fido

***NEW*** Training The Small Breed ***NEW***

CLICK HERE TO SEE THEM This will open a new window so you can come back to this form

Registration certificates MAILED to you via US Mail within 24 hours

Use your Mastercard, Visa or American Express Card

Please fill in ALL the Required boxes below

if you are missing information leave it blank

IMPORTANT READ THE CLASSIFICATION & REGISTRATION INFORMATION PAGES BEFORE FILLING OUT THIS FORM

If you having a problem with this form or have questions or call live line support at 516 942-4395

TO SEND PROOF OF BREED PHOTOS

Via E Mail

Do this when you register your dog

Email us at registra@optonline.net

include your name address phone # and your dogs name. Add as an attachment 2 jpeg images of your dog name them "my dogs name" side.jpeg & "my dogs name" head.jpeg

Example: If your dog is named BUNKY name jpegs bunkyside.jpeg & bunkyhead.jpeg

Via Regular Mail

Send to DRA PO Box 754 Plainview NY 11803

include your name address phone # and your dogs name. 2 photos of your dog with its name on the back. Certificate will be issued as soon as this is received

Dog's names should be unique.

We suggest the dog have at least 2 names up to 30 characters and spaces.

(Example: dog's name is Gizmo, owners name is Bill Jones, and they live on Lenox Rd the dog's name could be;

Gizmo Jones, Bill's Gizmo, Gizmo of Lenox, or Gizmo the Red Nosed Shih Tzu)

If a dog's name is common DRA has the right to add the owners name or numerals or other modifications to the requested name to avoid confusion and duplication

(example: dog's name is Gizmo owners last name is Jones, DRA may issue certificate with the dog's name as Gizmo Jones)

DRA reserves the right to refuse to register the dog with a requested name deemed unacceptable for any reason.

IMPORTANT If the Breeder gave you an application and are copying from it place the large 6 diget # in the grey box that says reserved for DRA use only herePedigrees are available for dogs having this number if you want one please select Registration with Seal and Pedigree from Registration Options below and check this box

YOUR EMAIL ADDRESS: required

Dog's Name : required

Breed: required

Color : required

Sex: required

Date Of Birth: Please use this format MM/DD/YYYY EXAMPLE (O1/01/2002)

Sire (father) Name:

Sire Registration No:

Dam: (mother)

Dam Registration No:

Breeder Information:

Who owned the Parents of Your dog

Breeder first name:

Breeder last name:

Breeder Address:

Breeder City :

Breeder State:

Breeder Zip:

Breeder Area Code:

Breeder Phone No:

Registrant Information: your information

First name of Owner OR Owner& Co Owner: required (Example John or John & Mary )
Last name of Owner OR Owner & Co Owner: required (Example Smith or Smith & Jones )
Address Including APT or LOT#: required
City : required
State: required
Zip: required
Area Code: required
Phone No : required
required For Security Purposes Re-Enter Your E-Mail:	Photo Proof Select :

Payment Method Select required

Use This Format Include Spaces example 1234 5678 9101 5555

Credit Card# required

Exp Date required

Name On Card required

Registration Options Select required Canadain Orders $5.00 additional

Security Code required The security code helps protect you against fraud. Visa & MC last 3 digits on back of card. AmX 4 digits on front.

required Add a 2-year membership in the DRA Lost Pet Recovery Service with ID TAG

only $10.00 additional

when ordered with Any Registration

CLICK HERE for info This will open a new window so you can come back to this form

NEW Training Manuals. Latest editions of the best selling Do It Right Series

CLICK HERE TO SEE IT This will open a new window so you can come back to this form

Add these books to my registration order and shipping is FREE!

NY State Residents will be charged NY State Sales tax on books.

QuantityItem # DRA101 Do It Right Psychology & Training $19.99 ea ~~plus $3.00 shipping Total $22.99~~

Quantity Item # DRA301 Small Breed Training $19.95 ~~plus $3.00 shipping Total $22.95~~

QuantityItem # DRA201 Fun Wit Fido $16.99 ea ~~plus $3.00 shippingTotal $18.99~~

FIREMAN SAVE MY DOG & CAT PET DECAL only $5.00 each with your registration order

CLICK HERE TO SEE IT this will open a new window so you can come back to this form

Quantity Item# DRAFD $5.00

If you have more dogs to register submit this form and come back to this page and start again

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YOUR EMAIL ADDRESS: required
Dog's Name : required
Breed: required
Color : required
Sex: required
Date Of Birth: Please use this format MM/DD/YYYY EXAMPLE (O1/01/2002)
Sire (father) Name:
Sire Registration No:
Dam: (mother)
Dam Registration No:
Breeder Information:	Who owned the Parents of Your dog
Breeder first name:
Breeder last name:
Breeder Address:
Breeder City :
Breeder State:
Breeder Zip:
Breeder Area Code:
Breeder Phone No: