UCA Registered Kennel Application




Register your exclusive kennel name with the UCA by using this registration form.
   LIFETIME kennel name registration includes special kennel benefits.  Registration benefits including sole and exclusive rights of the use of your kennel name with the UCA registration office and on all future UCA advertising (Example: Kennel Name is Rio Bravo Bulldogges, dog is named Rio Bravo's Jack Pot), priority on processing registration paperwork and free a listing on the UCA website kennel roster as a UCA registered Kennel.
Kennel Name (1st. Choice): *
If first choice is unavailable second choice will be used.
Kennel Name (2nd Choice):
Website Address:
Breed of Dog (s): *
1st. Applicant's Name: *

First
Last
Phone Number: *

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Email Address:
2nd. Applicant's Name:

First
Last
Phone Number:

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####
Email Address:
Mailing Address: *

Street Address

Address Line 2

City
State / Province / Region

Postal / Zip Code
Country
One Time Registration Fee: *
 $100 
Laminated Certificate:
 $5 (Additional) 
Credit Card Number:
Credit Card Expiration Date:
Credit Card Security Code:
 
    (3 digit number on the back of the card)
Name on the Credit Card:
Additional Information:

All applications are property of the UCA.  All personal information is confidential and will remain as such.

Applicants will be approved or denied at the discretion of the UCA.
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