Part Welsh Mare Registration Form - The Welsh Pony & Cob Society ...

THE WELSH PONY AND COB SOCIETY OF AUSTRALIA INCP O BOX 762, PAKENHAM VIC 3810PHONE (03) 5941 3288FAX (03) 5941 2248registrar@wpcs.com.au or www.wpcs.com.auABN 70 066 732 397PART WELSHMARETransfer of ownership may be made at the time of this application. New Owner must be a financial member to enable this registration toproceed. (Transfer fee is applicable)Transfer Date________________Owners Name___________________________________________________Membership No :______________Address:_________________________________________________________Postcode:_________________Phone No:_______________________________________Mobile:___________________________________Breeders Name:_________________________________________________Membership No:______________Address_________________________________________________________Postcode:_________________Phone No:______________________________________Mobile:____________________________________Name of Mare:_________________________________________________________________Percentage___________Maximum of 28 characters including prefix and spacesDate of Birth:______/_______/_______ Blue Eyes: Left RightBirth Colour:_________________________________ Expected Colour at Maturity_____________________________Sire__________________________________________________Rego No______________Colour_______%____Dam__________________________________________________Rego No______________Colour_______%____BREEDERS DECLARATION OF SERVICE PARTICULARSA signed service certificate is required if the Stallion is not owned/Leased.Tick to confirm S/C attachedThe Breeder is the recorded or legal owner or lessee of the Dam at the time of foaling. Please complete all dates of service.Where the breeder owns /leases the Stallion at the time of service the breeder declaration must be completed and signed.I declare that the Stallion________________________________________________Reg No_______________________Served the Mare_______________________________________________________Reg No_______________________Owned / Leased by me on____________________________________________________________________________Natural Service: Chilled Semen : Frozen Semen : Embryo Transfer :MARE FEE $38.50TRANSFER FEE $25.00REG NO______________DATE ________________I HEREBY CONFIRM THAT ALL PARTICULARS ARE CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF:Breeders Signature___________________________________________________Name:_________________________Owners Signature____________________________________________________Name:_________________________Office Records: Date Received_______________________ Receipt No______________________________________Amount__________________________ Card Holders Signature____________________________________________Cheque / Money Order or please charge my Visa MastercardExp Date

THE WELSH PONY AND COB SOCIETY OF AUSTRALIA INCIF YOU ARE UNABLE TO DRAW ANIMALS MARKINGS PLEASE ATTACH PHOTOS.ALL PONIES SHOULD BE BRANDED WITH THE BREEDERS BRAND AT TIME OF REGISTRATION.WHITE MARKINGS ONLY SHOULD BE NOTED.TICKEDWHORLSBODY PATCHESSHADE AREAS AS WHITE xPony Name:___________________________________________________Head & Body Markings:______________________________________________________________________________________________________Nearside Brand drawn and/ or writtendescription._____________________________Near Fore_____________________________________________________Hoof Stripe Y or NNear hind ___________________________________________________Hoof Stripe Y or NOffside Brand drawn and/ or writtendescription._____________________________Off Fore_______________________________________________________Hoof Stripe Y or NOff Hind_______________________________________________________Hoof Stripe Y or NMicrochip:Place sticker here.(Complusory if not branding)Notes: