THE AUSTRALIA PIG BREEDERS' ASSOCIATION LIMITED
ACN 003 671 485
PO BOX 189, KIAMA NSW 2533 Ph (02) 4232 3333 Fax (02) 4232 3350
APPLICATION FOR REGISTRATION
(Please complete all particulars in INK and in BLOCK LETTERS)
Name: …………………………………………………………………..
Member no: ………………………….
Stud Prefix: ……………………………………
Address: ………………………………………………………………………………………………………………...
……………………………………………………………………………… Postcode: ……………………………
Tattoo Brand: …………………………………
Date: ……………………………………………
Breed: ……………………………………………………………….….
(only one breed per page)
Name
Born
Sex
Tattoo
Sire
H.B. No
Dam
H.B. No
Full/Recorded
Amount enclosed for registration/recording fees: $……………………
I certify that the particulars shown are in true and correct and conform with the Rules and Regulations of the Association.
Signature: …………………………………
Please sign in (in left column) to submit registrations
Australian Pig Breeders
PO Box 189
Kiama, NSW, 2533
Phone: 02 4232 3333
Fax: 02 4232 3350
pigbreeders@lbcentre.com.au