Breeder

Owner of Dam (Mother) at foaling:

City:

State/Province:

Country/District:

Parentage Verification

SIRE OF APPLICANT HORSE:

Stallion Name* 

 Registry*  #*  

Color*   Unknown BLACK BROWN Bay WHITE WHITE WITH FRECKLES DARK GRAY LIGHT GRAY Chestnut Sorrell Red Dun Liver Grullo Palomino Cremello Dun Buckskin Perlino Smoky Black Smokey Creme Ivory Champagne Golden Champagne Classic/ Champagne Silver Dapple Red Silver Dapple   Body Pattern if applicable:   Solid /white Roan Brindle Tobiano Overo Tovero Splashed White Medicine Hat Sabino Frosted Blanket leopard frosted Other

Owner*(at time of breeding)  NQHR Member YES  NO       #  

Address*  City*  State*

Zip*     Email     Phone

Sires sire

 Name*  Registry*  #*   

Color  Unknown BLACK BROWN Bay WHITE WHITE WITH FRECKLES DARK GRAY LIGHT GRAY Chestnut Sorrell Red Dun Liver Grullo Palomino Cremello Dun Buckskin Perlino Smoky Black Smokey Creme Ivory Champagne Golden Champagne Classic/ Champagne Silver Dapple Red Silver Dapple Body Pattern if applicable:   Solid /white Roan Brindle Tobiano Overo Tovero Splashed White Medicine Hat Sabino Frosted Blanket leopard frosted Other

Sires Dam

Name*  Registry*  #*  

Color  Unknown BLACK BROWN Bay WHITE WHITE WITH FRECKLES DARK GRAY LIGHT GRAY Chestnut Sorrell Red Dun Liver Grullo Palomino Cremello Dun Buckskin Perlino Smoky Black Smokey Creme Ivory Champagne Golden Champagne Classic/ Champagne Silver Dapple Red Silver Dapple Body Pattern if applicable:   Solid /white Roan Brindle Tobiano Overo Tovero Splashed White Medicine Hat Sabino Frosted Blanket leopard frosted Other

DAM OF APPLICANT HORSE:

Mare Name*   Registry*  #*  

Color*   Choose One BLACK BROWN WHITE WHITE WITH FRECKLES DARK GRAY LIGHT GRAY TAN RED PEACHY RED DARK RED SILVER ORANGISH COPPER GOLD YELLOW CREME  Body Pattern if applicable:   Solid /white Roan Brindle Tobiano Overo Tovero Splashed White Medicine Hat Sabino Frosted Blanket leopard frosted Other

Owner*(at time of breeding)  NQHR Member YES  NO       #  

Address*  City*  State*

Zip*     Email     Phone

Dams Sire

Name*  Registry*  #*  

Color*   Choose One BLACK BROWN WHITE WHITE WITH FRECKLES DARK GRAY LIGHT GRAY TAN RED PEACHY RED DARK RED SILVER ORANGISH COPPER GOLD YELLOW CREME  Body Pattern if applicable:   Solid /white Roan Brindle Tobiano Overo Tovero Splashed White Medicine Hat Sabino Frosted Blanket leopard frosted Other

Dams Dam

Name*  Registry*  #*  

Color*   Choose One BLACK BROWN WHITE WHITE WITH FRECKLES DARK GRAY LIGHT GRAY TAN RED PEACHY RED DARK RED SILVER ORANGISH COPPER GOLD YELLOW CREME  Body Pattern if applicable:   Solid /white Roan Brindle Tobiano Overo Tovero Splashed White Medicine Hat Sabino Frosted Blanket leopard frosted Other

Optional: If you would you like N.Q.H.R staff to complete any missing pedigree information: Color, reg. numbers, etc. This is optional and is a flat fee of $10.00 and is only available for parents/grandparents who have been recorded with N.Q.H.R or another official registry.  

YES

Please keep in mind the more complete your certificate is the more valuable it becomes.   

 VERIFICATIONS

Name of person completing application:* 

 By submitting this form I agree to release all the information herein to the National Quarter Horse Registry for recording and educating purposes. I understand that the names, address and personal information on this application will not be released to anyone with out my permission, unless requested by a court of law. I agree to abide by all the rules, regulations, and any amendments made thereto by N.Q.H.R..  I further understand and agree by joining N.Q.H.R. or by purchasing, transferring, filling for registration, or any other service provided by the National Quarter Horse Registry I warrant I will not commence any action whether in law or equity against the National Quarter Registry in any court federal or state. I understand that by clicking the agree button below I am entering my digital signature to this application hereby certifying that I am the legal owner of the applicant horse, and all of the information being submitted on the application is true and correct to the best of my belief and knowledge.*