Miniature Stock Certificates

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					                     North American
                     Miniature Australian Shepherd Club of the USA, Inc.
                          PO Box 141097, Broken Arrow, OK 74014-1097
                          Phone/Fax: 918-357-5844   e-mail: registrar@namascusa.com                           web: www.namascusa.com

           HARDSHIP DOG REGISTRATION APPLICATION
          This application is only for dogs with no prior NAMASCUSA/MASCA/NSDR Registration
             The following rules must be followed completely for this application to be accepted.
                             Print CLEARLY or type, use only blue or black ink.
Rules:
  1) An ASDR and/or APRI registered Australian Shepherd will not be registered as a Miniature Australian Shepherd unless it has
     an ASDR or APRI miniature Australian Shepherd number.

  2) If the sire and dam are registered with NAMASCUSA, MASCA or NSDR as a Miniature Australian Shepherd, the dog can
     not be eligible for registration via a Hardship Registration.

  3) The dog is not eligible to be registered using a Hardship application if its litter is already registered or can be registered with
     NAMASCUSA. If the litter is registered or can be registered with NAMASCUSA, the dog must be registered using the
     “Yellow” litter registration individual dog application.

  4) If the dog or its parents are registered with a registry other than NAMASCUSA, enclose copies of their registration
     certificates. The NSDR temporary registration letter is only accepted with copies of the parents registration certificates. An
     application to ASDR or APRI will not be accepted as a registration certificate.

  5) Provide a copy of a 3-generation pedigree (behind the dog), complete with all dog’s registration numbers and registered
     names. The dog must go back to NAMASCUSA, MASCA or NSDR registered miniature Australian Shepherds within the
     three generations; with 1/8 of the pedigree going back to the NAMASCUSA, MASCA or NSDR registered miniature
     Australian Shepherd.

  6)   Enclose 9 pictures of the dog:
       Left/Right sides standing with measuring stick                     Left/Right sides standing without measuring stick
       Front/Back standing                                                Head- Left/Right sides and Front

  7) Once a dog is registered with NAMASCUSA, the registered name will not be changed, except as provided for by the
     Registry Rules, Name Change Rules, and by Appeal to the NAMASCUSA Board of Directors. The registered name will not
     be changed (if dog has earned show points, titles or produced or sired a litter under that name). Correction to spelling or
     punctuation maybe made if requested by the owner of the dog within 60 days of certificate issue date and prior to any
     offspring being registered to said dog. The signature of the owner(s) must accompany the corrections. Punctuation or
     spelling errors made by the applicant require a change fee of $10. Errors made by the Registrar will be corrected at no
     charge. Return the original certificate to the registry with the corrections noted.

   8) The dog must be micro-chipped or tattooed, and said information provided on the application for Hardship Registration.

   9) The application will be reviewed by the Hardship Registration Committee before the registration will be issued. The dog
      must conform to the NAMASCUSA Breed Standard.

                       Registration Fee: $45.00 Eligible dogs must be 12 months of age or older -
                                Registration Fee must accompany the application. Fees are doubled for non-members.
                  Make Check or Money Order payable in $USA to NAMASCUSA (A $25 fee will be charged for all returned checks)
                              Mail to: NAMASCUSA Registry Office, PO Box 141097, Broken Arrow, OK 74014-1097
       Payments by credit card & Paypal available with a 3% added charge for Domestic & 4% for International Email for a Paypal invoice:
                                                           registrar@namascusa.com
                                                                       Checklist:
                  Applicant to complete all information in Section A                         Attach copies of dog or parents registration certificates, as
                  required
                  Breeder to complete and sign Section B                                      Attach a copy of a 3-generation pedigree

                  Kennel owner to complete and sign Section C, if required                    Include 9 color photos

                  Owner to complete and sign Section D                                        Include payment of the fee - Doubled For Non-Members
                        North American
                        Miniature Australian Shepherd Club of the USA, Inc.
                             PO Box 141097, Broken Arrow, OK 74014-1097
                             Phone/Fax: 918-357-5844    e-mail: registrar@namascusa.com                          web: www.namascusa.com

            HARDSHIP DOG REGISTRATION APPLICATION
         PLEASE PRINT CLEARLY OR TYPE ALL INFORMATION, USE BLACK OR BLUE INK ONLY
SECTION A
____________________________________________________________________________________________________________
 Dog’s Registered Name                                                           Micro-chip Number or Tattoo

____________________________________________________________________________________________________________
 Current Registration Number               Registry                     Sex                   Date of Birth

____________________________________________________________________________________________________________
 Body Color: Blue Merle, Red Merle, Black or Red                               Trim Color: White and/or Copper

____________________________________________________________________________________________________________
 Eye Color:   Left           Right                           Tail: Docked, Natural Bob, Natural Bob/Docked or Full

____________________________________________________________________________________________________________
  Registered Name of Sire                         Registration Number                 Registry

____________________________________________________________________________________________________________
 Registered Name of Dam                           Registration Number                 Registry

SECTION B                               *** This dog is not to be bred when this box is checked * ***
________________________________________________________________________________________
 Name of Breeder(s)                                Street Address                           City                State                Zip Code

_________________________                          _________________________________________________________
Date Owner Acquired Dog                                                Phone Number                                       e-mail Address

________________________________________________________________________________________
Breeders Signature                                           Breeder Co-Owners Signature                                             Date

SECTION C
I hereby give my permission and require the use of my kennel name _________________________________ in naming this dog.

________________________________________________________________________________________
Kennel Owners Signature                                      Kennel Co-Owners Signature                                          Date

SECTION D
This application only constitutes consideration for registration and does not guarantee registration with the NAMASCUSA. I (we) certify that all
data submitted on and with this application, is correct. I (we) understand that all applications become the property of NAMASCUSA. If an
application is falsified or denied, no registration will be issued and the fees will not be refunded. I (we) further understand that as an owner of a
NAMASCUSA registered dog, I (we) agree to abide by the NAMASCUSA Registry Rules and Regulations, Bylaws and Code of Ethics.

__________________________________________________________________________________________
 Name of Owner/Co-Owner                                                          Phone Number                             e-mail Address

__________________________________________________________________________________________
 Street Address                                    City                State                Zip Code           NAMASCUSA Membership #

__________________________________________________________________________________________
Owners Signature                                 Co-Owners Signature                                                      Date
                                       All incomplete applications will be returned to owners after 90 days                         DRAFT: 02/09 Approved 2/09

				
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