Biewer Breed International Registry
“Dedicated to Honesty and Excellence”
Single Domestic Dog Registration/Pedigree Application
Fee for Registration: $15 per dog, $10 for members of the BBCI
Fee for 4 generation pedigree: $25 per dog, $15 for members of the BBCI
Owners Last Name:___________________________________ First __________________________
Kennel Name if applicable: _____________________________________________________________
Address: ____________________________________________________________________________
City: ________________________ State: __________ Zip code: _______________________________
Phone number: ___________________________________ E-mail: ____________________________
If needed:
Co-Owners Name:
____________________________________________________________________________________
Kennel Name:
_________________________________________________________________________________________
City: _______________________ State: ___________ Zip code:
________________________________________________
Phone number: __________________________________ E-mail:
_______________________________________________
When submitting an application, please include the following items:
• A 3-5 generation pedigree of parents (if it is a puppy and no pedigree has been issued yet) or of dog
(photo copy allowed)
• Check for fee/pedigree application made out to BBIR, (Biewer Breed International Registry)
• Photocopy of DNA Profile Certificate (for full registration ~ breeding quality) and must be issued from
MMI DNA Laboratory.
• Micro chip number or tattoo number if applicable
• 4 photos of dog in question: 1) Left side (full body view)
2) Right side (full body view)
3) Full face
4) Top view
If requested, a laminated pedigree will be issued with 4 generations listed. If you would like a picture included,
please send through e-mail to: biewerbreedclubint@yahoo.com along with your name.
Please note: All photographs, copies of the DNA certificates and pedigrees given to the BBIR shall be the sole
property of the BBIR and will not be reproduced or distributed in any way. Photographs will not be returned.
Optional items that can be submitted with application:
• A copy of your dog’s CERF and /or OFA form signed by the appropriate authority showing results. Must be
submitted if you want the BBIR to list “Yes” under the CERF & OFA information line.
• Breeding restrictions (if applicable)
• Any other notations please place below
Applicant Dog Information
Dogs Registered Name : _____________________________________________________________
Chip or Tattoo Identification #: _______________________________________________________
Date of birth: ___________________________ Sex: M ________ F _______ Altered ____________
Breeders Name: ________________________________ Breeders Kennel Name: _______________
Sire’s Registered Name & Number: _____________________________________________________
_____________________________________________
Dam’s Registered Name & Number: ____________________________________________________
_____________________________________________
OFA Certification (knees) ________________________ CERF (eyes) _________________________
By signing, I (we) testify that all the data submitted above is correct. I (we) understand that all information
becomes the property of the BBIR (Biewer Breed International Registry). The BBIR will do it’s utmost to verify all
information submitted. The information provided is solely the applicant’s responsibility to be correct. If the BBIR
finds falsified records they are entitled to all fees paid and no pedigree or registration shall be issued. The
information will be kept private, only for the BBIR, and any other use shall require permission of the owner. The
BBIR will not be responsible for any pedigree information that is prior to the BBIR’s registration date of the dog.
Pedigree requested: YES___________ No _______
Signature of Owner: _____________________________________________________
Signature of Co-owner: ___________________________________________________
Date: __________________________________________________________________
Mail to:
BBIR
c/o Theresa Perry
4571 Douglas Rd.
Ida, Michigan 48140 USA (Office Use Only)________________________
“Dedicated to Honesty and Excellence”
Single Domestic Dog Registration/Pedigree Application
Fee for Registration: $15 per dog, $10 for members of the BBCI
Fee for 4 generation pedigree: $25 per dog, $15 for members of the BBCI
Owners Last Name:___________________________________ First __________________________
Kennel Name if applicable: _____________________________________________________________
Address: ____________________________________________________________________________
City: ________________________ State: __________ Zip code: _______________________________
Phone number: ___________________________________ E-mail: ____________________________
If needed:
Co-Owners Name:
____________________________________________________________________________________
Kennel Name:
_________________________________________________________________________________________
City: _______________________ State: ___________ Zip code:
________________________________________________
Phone number: __________________________________ E-mail:
_______________________________________________
When submitting an application, please include the following items:
• A 3-5 generation pedigree of parents (if it is a puppy and no pedigree has been issued yet) or of dog
(photo copy allowed)
• Check for fee/pedigree application made out to BBIR, (Biewer Breed International Registry)
• Photocopy of DNA Profile Certificate (for full registration ~ breeding quality) and must be issued from
MMI DNA Laboratory.
• Micro chip number or tattoo number if applicable
• 4 photos of dog in question: 1) Left side (full body view)
2) Right side (full body view)
3) Full face
4) Top view
If requested, a laminated pedigree will be issued with 4 generations listed. If you would like a picture included,
please send through e-mail to: biewerbreedclubint@yahoo.com along with your name.
Please note: All photographs, copies of the DNA certificates and pedigrees given to the BBIR shall be the sole
property of the BBIR and will not be reproduced or distributed in any way. Photographs will not be returned.
Optional items that can be submitted with application:
• A copy of your dog’s CERF and /or OFA form signed by the appropriate authority showing results. Must be
submitted if you want the BBIR to list “Yes” under the CERF & OFA information line.
• Breeding restrictions (if applicable)
• Any other notations please place below
Applicant Dog Information
Dogs Registered Name : _____________________________________________________________
Chip or Tattoo Identification #: _______________________________________________________
Date of birth: ___________________________ Sex: M ________ F _______ Altered ____________
Breeders Name: ________________________________ Breeders Kennel Name: _______________
Sire’s Registered Name & Number: _____________________________________________________
_____________________________________________
Dam’s Registered Name & Number: ____________________________________________________
_____________________________________________
OFA Certification (knees) ________________________ CERF (eyes) _________________________
By signing, I (we) testify that all the data submitted above is correct. I (we) understand that all information
becomes the property of the BBIR (Biewer Breed International Registry). The BBIR will do it’s utmost to verify all
information submitted. The information provided is solely the applicant’s responsibility to be correct. If the BBIR
finds falsified records they are entitled to all fees paid and no pedigree or registration shall be issued. The
information will be kept private, only for the BBIR, and any other use shall require permission of the owner. The
BBIR will not be responsible for any pedigree information that is prior to the BBIR’s registration date of the dog.
Pedigree requested: YES___________ No _______
Signature of Owner: _____________________________________________________
Signature of Co-owner: ___________________________________________________
Date: __________________________________________________________________
Mail to:
BBIR
c/o Theresa Perry
4571 Douglas Rd.
Ida, Michigan 48140 USA (Office Use Only)________________________
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