PTCA Yearly Members Single Registration | Patterdale Terrier Club of America

Yearly memberships MUST be paid up-to-date to register a terrier using the following form. To pay your yearly membership or to become a lifetime member please register here.

Date*

Owners Name*

First

Last

Mailing Address*

(Address where you receive USPS mail) City State / Province / Region Postal / Zip Code Country

Phone*

Email*

As The Breeder

I attest that the Patterdale Terrier indicated on this Registration Application was the result of the breeding by the above listed Sire and Dam and was sold to the undersigned Owner.

Breeder Name*

First

Last

Breeders Phone Number Used By PTCA To Confirm Signature*

As New Owner,

I attest that I was informed by the Breeder that the Patterdale Terrier indicated on this Registration Application was the result of the breeding by the above listed Sire and Dam.

New Owner*

First

Last

The PTCA Terrier Registration Fee for Yearly Members is $15. After submitting you will receive an invoice from The PTCA at the email address you provided above for this fee.

Terrier's name as it will appear on Certificate (The Breeder's Name or Kennel Name should be part of the Terrier's Name)*

Gender*

Make

Female

Coat Color*

Black

Red

Chocolate

Black & Tan

Coat Type*

Smooth

Broken

Rough

Sire's Name (And PTCA number If registered)*

Dam's Name ( And PTCA number if registered)*

To register a terrier the PTCA requires individual front and side photos of the terrier. Each photo MUST be a close-up representing 75% of the terrier.

In addition to photos a 3 generation of your terrier MUST be uploaded. This can be legibly handwritten pedigree submitted as a photo using your phone or it can be a photocopy of an existing pedigree

Please upload those 3 items below

Front Photo*

Side Photo *

3 Generation Pedigree*

Need a blank pedigree? Please download this pedigree then fill in the blanks then take a photo and attach as a file