Application for Registration – American Mi-Ki Registry Association

Are you registering this Mi-Ki as Pet or Breeder?

Pet

Breeder

Is Mi-Ki spayed/neutered?

Yes

Pay by PayPal to:
amra06@msn.com

Current club membership (if any):

Today's Date:

Owner Information

Owner Name:(Required)

First Last

Address

Street Address City State ZIP Code

Phone:

Cell phone:

Email:(Required)

Kennel Name (if applicable):

Website (if applicable):

Co-Owner's Name:

First Last

Address

Street Address City State ZIP Code

Phone:

When submitting your application, please include the following required items: Note: Photos to be sent in jpg format to: amra06@msn.com.

A three to five generation pedigree. Note: If more generations are required, it is up to the owner to provide proper information.
Copy of applicant dog’s current Registration Certificate from approved Mi-Ki club or registry. If registration is not from a Mi-ki registry, then a current Wisdom Panel or Embark breed test must be done and results submitted along with current registration certificate.
Two current photos – One full front & one full side view of dog standing. (Must be able to see feet.) May submit third photo to be used on AMRA Certificate of Registration.
A copy of applicant dog’s DNA profile from BioPet Vet Lab.

Please note: All photos, DNA certificates, and pedigrees given/obtained by AMRA shall be the sole property of AMRA and can be reproduced or used in any way AMRA deems appropriate. No photos will be returned. Optional items to submit with application:

A copy of your dog’s CERF and OFA forms for eyes, patellae and heart signed by the appropriate authority rendering results. (Must be submitted if you want AMRA to list testing on breeders’ page on the AMRA website.)

The CERF & OFA certificates are for data collection purposes and will be used to produce statistical information pertinent to the Mi-Ki. The results of your tests will not be shared with anyone without your expressed consent.

Upload Files

Drop files here or

Accepted file types: jpg, pdf, Max. file size: 256 MB.

Signature of Owner:

Date

Signature of Co-Owner:

Date

Applicant Dog Information

Dog's Registered Name:

Registration Number:(Required)

Males: Both testicles descended by 6 mo?

Yes

Sex:(Required)

Male

Female

Current Registry:

Date of Birth:

Breeder's Name:

Breeder's Kennel Name:

Sire’s Registered Name:

Sire’s Registration Number:

Sire’s Current Registry:

Dam’s Registered Name:

Dam’s Registration Number:

Dam's Current Registry:

Coat Type:(Required)

Smooth

Long

Ear Set:

Down

Color:

Height at Sholder:

Weight:

Microchip/Tattoo Number:

Bite:

Muzzle Length:

By signing, I (we) testify that all data submitted above is correct. I (we) understand that all applications become the property of AMRA. If an application has been falsified, no registration certificate will be issued and fees will not be refunded. If it is discovered, after registration, that any part of this application has been falsified, registration will be revoked for this dog and any progeny. The pedigree and all other information concerning any animal is provided by, and is solely the responsibility of, each respective owner. Each owner agrees to indemnify, hold harmless and defend this limited liability company and all its members and representatives from any claim or damages whatsoever based on any inaccurate or misleading information at any time provided by such owner. Venue of any dispute shall be exclusively in Pierce County, Washington, and the prevailing party shall be entitled to recover its reasonable attorney fees and all reasonable costs of litigation in addition to any relief awarded by the court.

Signature of Owner:

Date

Signature of Co-Owner:

Date

AMRA Information

This application only constitutes consideration for registration and does not guarantee registration with AMRA. Each application for registration is considered on its merit. AMRA reserves the right to reject an application. The granting of a registration is at the sole discretion of AMRA. Mail or email application to: American Mi-Ki Registry Association (AMRA) c/o Tamara Beebe 7701 W. Acoma Drive Peoria, AZ 85381 (amra06@msn.com)

AMRA Approved:

Date: