WSSDCA Litter Registration Form

WHITE SWISS SHEPHERD DOG CLUB OF AUSTRALIA INC. A0043538A

LITTER REGISTRATION FORM
This form may be returned to the breeder unless payment has been made and form correctly filled out including signatures.
Registration names not to be longer than 30 letters including kennel name and spaces.
If puppies still with breeder after 12 weeks, please submit form with the Sale Pending boxes ticked to avoid late fee penalties.
Online Stud Service form, or PDF (signed) Stud Service form can be found on the Club website and must be completed and submitted with Litter Registration Form.
Breeder's Prefix *
Breeder's Full Name *

First Name Last Name
Sale Pending? *
Breeder's E-mail *
Dam's Registered Name *
Dam's Registered Number *
Sire's Registered Name *
Sire's Registered Number *
Date of Whelp *

Day Month Year
Payment Type *

EFT Cheque/Money Order
ELECTRONIC FUNDS TRANSFER

Bank: Commonwealth Bank Account Name: White Swiss Shepherd Dog Club
BSB: 063 301 Account Number: 10055290

(Please ensure you include at least your surname with the EFT Payment so we can reconcile who it is from)

CHEQUE or MONEY ORDER (Payable to the 'WSSDCA INC')

FEES

Litter registration $20 (per puppy)

LATE FEES

If registered between:

12-16 weeks $50 (per litter)

16-26 weeks $150 (per litter)

After 26 weeks $500 (per litter)
Litter Registration Details *
Stud Form *
Please attached Stud Service Certificate
Breeder’s Declaration

I declare that the above particulars are true and correct, and that all live offspring from this mating have been recorded.
Breeder's Signature *

Clear
Please verify that you are human *
Should be Empty:

WHITE SWISS SHEPHERD DOG CLUB OF AUSTRALIA INC. A0043538A