Harlequin Pinscher Association
Registration Privilege Application
P.O. Box 360
Fouke, Arkansas 71837
$25.00 annual dues (*$10.00 per additional household applicant)
Phone #: _____________________________________________Breeder #:_____________
Email Address: ______________________________________________________________
Kennel Name: ____________________________________________________________________
List any other dog registry you are currently using: _____________________________
Are you now or have ever been suspended/banned from another registry? _______
If so which registry:____________________________ dates:_______________________________________________________________________________
I would like to be placed on the breeders list on the HPA website?_______________
I hereby apply for Registration Privileges into the HPA for the 2018-19 Calendar year.
I have read, understand and agree to abide by the Code of Ethics, Standards of Procedures, Policies and Terms of Registration. I am aware my Registration Privileges may be terminated at any time for just cause.
I do hereby consent to a background check. I understand my privileges will be terminated and all of my registered Harlies HPA papers will be pulled if I register Harlies with any other registry other than ACR/HPA/APR after the date of this application.
I attest I have never been convicted of animal abuse or neglect.
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