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Breeder Registration Form

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* Required Fields

First Name *

Last Name *

Kennel Name

Telephone *

( ) -

Address 1 *

City *

State *

Zip *

Email Address *

Personal Profile

1. How many and what breed of dogs do you care for? *

Primary Breed:	Number of Adults:	Number of Breeding Females:	Number of Puppies Born per Year:	Breeder Club Member:
				YesNo
Other Breeds:	Number of Adults:	Number of Breeding Females:	Number of Puppies Born per Year:	Breeder Club Member:
				YesNo
				YesNo

2. What primary brand of dog food do you feed and recommend?

Puppies:

Adults:

3. Where do you usually purchase your dog food?

SupermarketMass MerchantPet StoreDistributorFeed DealerVeterinarian

4. Which of these describes your dog involvement? (select all that apply) *

HuntingHerdingTrainingShowSledding/PullingAgilityCompanionOther

5. Please list dog or conservation organizations you belong to:

6. How did you hear about the Native Performance Breeder Program? *

AdvertisementBreeder ClubVeterinarianDistributorKent Sales RepKent WebsiteRetailerOther

Please note that the Native Performance Breeder Program is intended for individual breeders and enthusiasts, not institutional organizations, such as rescue groups, humane societies, or animal shelters.

Leaders in animal nutrition since 1972

Kent Pet Foods

Breeder Registration Form