Duplicate Registration Certificate

"*" indicates required fields

Contact Info*
Member Status*
When renewing your membership, if you change the membership type you will receive a new membership number. For example, dual to single or single to service.
If Renewing Membership:
Membership Fee:
I certify that I own the dog named above. Upon signing I (we) testify that all data submitted is correct. I (we) understand that all applications become the property of ASCA. If an application has been falsified, no registration certificate will be issued and fees will not be refunded. I (we) further understand that as an owner of an ASCA registered dog, I (we) agree to abide by the ASCA Articles of Incorporation, Bylaws, and Rules of Registries, Conformation, Obedience, Rally, Dock Jumping, Scent Detection, Agility and Stock Dog Programs and to disciplinary action, if necessary, as determined by the Board of Directors of ASCA.
Duplicate Registration Certificate Fees*
Credit Card*
American Express
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Expiration Date