Service Certificate by Anarbor

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									                                             Service Certificate
                   (To be completed by the owner (s) of the sire and countersigned by the owner of the bitch)

I/We ______________________________________ being a financial member of the North Australian Canine

Association, hereby certify that the bitch

                                                                                              was served by
                                                                    (REGN. NO.)
             (NAME OF BITCH)

                                                                                              on

             (NAME OF SIRE)                                         (REGN. NO.)                       (DATE OF MATING)


and the sire was visibly entire (not a monorchid).
                                                                 ____________________________________ / /
_________________________________ / /                                (SIGNATURE OF OWNER OF BITCH)/DATE
 (SIGNATURE OF OWNER OF SIRE)/DATE               09876543210987654321098765432121098765432109876543210987654321
                                                 09876543210987654321098765432121098765432109876543210987654321
                                                  ARTIFICIAL INSEMINATION
                                                 09876543210987654321098765432121098765432109876543210987654321
                                                 09876543210987654321098765432121098765432109876543210987654321
                                                 09876543210987654321098765432121098765432109876543210987654321
ADDRESS _______________________                   If bitch artificially inseminated, provide NAME, ADDRESS
                                                 09876543210987654321098765432121098765432109876543210987654321
                                                 09876543210987654321098765432121098765432109876543210987654321
                                                 09876543210987654321098765432121098765432109876543210987654321
                                                  AND SIGNATURE of Veterinarian who performed the “A.I.”.
                                                 09876543210987654321098765432121098765432109876543210987654321
                                                 09876543210987654321098765432121098765432109876543210987654321
                                                 09876543210987654321098765432121098765432109876543210987654321
                                                  Name:
_______________________________                  09876543210987654321098765432121098765432109876543210987654321
                                                 09876543210987654321098765432121098765432109876543210987654321
                                                  Address:
                                                 09876543210987654321098765432121098765432109876543210987654321
                                                 09876543210987654321098765432121098765432109876543210987654321
                                                 09876543210987654321098765432121098765432109876543210987654321
_______________________________                  09876543210987654321098765432121098765432109876543210987654321
                                                 09876543210987654321098765432121098765432109876543210987654321
                                                 09876543210987654321098765432121098765432109876543210987654321
     (MEMBERSHIP NUMBER)                          Signature: __________________________ Date: ____________
                                                 09876543210987654321098765432121098765432109876543210987654321
                                                 09876543210987654321098765432121098765432109876543210987654321

NOTES ON COMPLETING THIS FORM:
1.       SERVICE CERTIFICATE:                 The Service Certificate MUST be signed by the owners of both sire and dam
                                              regardless of the fact that they may be owned by the same person.

         Important:        * The owner of both the sire and the dam MUST hold NACA membership before any application can
                              be processed - interstate owners of stud dogs excepted.
                           * An interstate or overseas registered dam must be Re-registered with the NACA before their
                             progeny can be registered.

2.       APPLICATION FOR REGISTRATION:
         Important: One (1) application for registration only will be accepted in respect of any one litter.
         # An application for registration may be lodged at any time within eighteen (18) calendar months of the date of whelping
         # The application for registration must be submitted by the Breeder of the litter and must include all details of ALL DOGS
           from the litter.
         # A dogs name may include any number of words providing the number of digits including the Prefix and spaces does
           not exceed Twenty-Four (24) units. Certain words are not permitted as common names:- Refer Rules 7.4.1 - 7.4.3.
         # If you do not supply a second choice common name and your first choice is rejected a name will be selected and
           registered for you. Once a puppy name has been entered on the computer this name cannot be changed.

SCALE OF FEES (to be paid by BREEDER):
         Within three (3) calendar months of the whelping date the following fees (per puppy) will apply:
         Registration:
         Main:                      $16.50                              Registration plus Transfer (to new owner):   $33.00
         Limited:                   $ 5.50                              Registration plus Transfer (to new owner):   $22.00

       After three (3) calendar months but within eighteen (18) months the following fees (per puppy) will apply:
       Registration:
       Main:                      $27.50                              Registration plus Transfer (to new owner):     $44.00
       Limited:                   $16.50                              Registration plus Transfer (to new owner):     $33.00
The completed application form should be forwarded, together with your remittance to:
THE NORTH AUSTRALIAN CANINE ASSOCIATION Inc.
PO BOX 37521, WINNELLIE NT 0821

								
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