International Pinto Arabian Registry, Inc.
Registration Form Eligible Horse

I request this horse be registered under the following name.
Please limit your name choices to 20  letters.  We will try to use your first choice, but please list 3 choices.
(Print Very Clearly)

1st Choice _______________________________________________________    2nd Choice __________________________________________________________

3rd Choice ________________________________________________________________   (All of this info. is for your certificate, so we must be able to read application)

              Information about your horse:                                                                                Pedigree Information      Registry Number

Percentage of Arabian Blood ______________%            Sire: ______________________________________________________________

  Date Foaled ________________________________                         Sire's Sire _______________________________________________________

  Stallion _______   Mare _______  Gelding _______                           Sire's Dam ______________________________________________________

  Stock Pleasure ________     Saddle Gaiting_______                 Dam ______________________________________________________________

  Color ________________     Type _______________                          Dam's Sire ______________________________________________________

  Tobiano _______   Overo _______   Solid _________                         Dam's Dam _____________________________________________________
  
  Bred by ____________________________________ State________    (Please include other registration papers to verify % Arabian Blood.)

  Please be sure to include FOUR photos, front, rear, right side, & left side. (Please be sure to include the whole body)
  To register your horse - Members = $35.00                          Non-members $50.00
                                                                                                                                        
*Are your IPAR Membership dues current?  Yes, my membership number________________  / No ____ (I would like to become a member)
                                                                                                                                                                               Membership Fee = $30.00 (Annually)
     Owners Information:
  This horse is to be registered to _____________________________________________________________________________________________________________
                                                                                 
Address ______________________________________________ City ______________________________________ State _____________ Zip __________________

Day Phone (    ) _____________________________  Night (    ) ______________________________   e-mail ____________________________________________
  
To be completed for first time foal registration only. 

              Stallion's Owner Statement                        Mare Owner's Statement                                         
         I certify that I bred the Stallion named below:                                                    I certify that I owned the mare named below.
    
  Name ________________________________________________                            Name __________________________________________________________

Registration & No. ____________________________________                            Registration & No. ______________________________________________
  To the Mare named below:                                     The date the foal was born, to the best of my knowledge, and there are
                                   no liens or other encumbrances on this foal.
Name _________________________________________________

On this day ________ month _____________year ___________                     Signature _______________________________________________________

Signature _____________________________________________                     Co-owner _______________________________________________________

  Signature of Owner ____________________________________                                                                                
Copyright (c) IPAR 2009 All rights reserved.



2010
IPAR, INC.