PHILIPPINE CANINE CLUB, INC.
Rm. 206 Hillcrest Condominium
1616 E. Rodriguez, Sr. Avenue corner Hillcrest Street
Cubao, Quezon City, Philippines
Tel: +63 (2) 7218345 / Fax: +63 (2) 7217152
Email: info@pcci.org.ph
Website: www.pcci.org.ph
LISTING APPLICATION FORM
Date: ____________________________ Breed: __________________________
Name of Dog: __________________________________________________________
Sex: _________________________ Date of Birth: __________________________
Color & Markings: _______________________________________________________
Microchip No: __________________________________________________________
Sire Name: ____________________________________________________________
Sire Reg. No: __________________________________________________________
Dam Name: ____________________________________________________________
Dam Reg. No: __________________________________________________________
Breeder: ______________________________________________________________
Name of Owner(s): ______________________________________________________
PCCI Membership No: ___________________________________________________
Address: ______________________________________________________________
______________________________________________________________
Tel No: __________________________ Email: ___________________________
OR Number: _____________________ OR Date: _______________________
Note: Attached colored pictures of the dog (front & side view).