Application for ACC Registration Certificate and Pedigree
Send completed application for the Coton you wish to register with ACC along with either a copy of ACC litter registration, a three generation pedigree from another registry, or copies of the pedigrees of sire and dam, to ACC, 3484 Waverley Street, Palo Alto, CA 94306. The registration fee for a single dog is $30.  Additional dogs are $20 each when submitted at the same time. The registration fee for individual dogs from the same litter submitted together is $20 for each dog in the litter.

Name of Coton (formal or kennel name)____________________________________________________
Birthdate _______________ Sex ________
Bite scissors__ overshot__ undershot __ level or pincer__ other (describe)_____________________
Nose black__ brown (tobacco) __ spots of pink __ pink__ other (describe) _____________________
Lips black__ partially black __ other (describe)___________________________________________
Eyes full black rim (1 mm wide) around both eyes__ spotted rim__ no black rim _
Tail over back at rest __ hanging down with upcurl at rest__ other (describe)____________________
Male Genitals both testicles fully descended__one __ none __Altered yes__ no __
Color (describe markings) _______________________________________________________________
Pet (Companion)__  Show/potentially breedable (as specified by breeder)__ Breedable (Health tests submitted)____
Cotons under one year of age will be given a limited registration either as a Companion or as Potentially Breedable.  ACC registration as Breedable (and eligible for listing in the separate ACC Breeding Registry) can be obtained for a Coton older than one year which has ACC Health Test Certification. Requirements include CERF (an eye exam by a certified veterinary ophthalmologist) and a minimum of two more certified tests from the following list:  OFA patella, OFA cardio, OFA thyroid, OFA/Penn-hip hips, OFA/Penn-hip elbows,  full blood chemistry with CBC.  There is no charge for reissue of a pedigree and registration from potentially breedable to breedable.  See ACC Health Testing Program for details.

Breeder name ________________________________Kennel name____________________________
Address _________________________________________
Phone Number _____________ email ______________________Date Purchased_________________
Sire_______________________________ Owner ______________ Registration Number_____________
Dam ______________________________ Owner ______________ Registration Number_____________
(CTCA, FCI and USACTC Pedigrees and Registration Numbers are accepted. ACTA, SKC, UKC
Registrations may require further verification but are also acceptable).
Owner Name ______________________   Co-Owner (if applicable)_____________________
Kennel Name _______________________ Co-Owner Kennel Name______________________
Address _____________________________________ Address__________________________________
Phone Number ________________________________ Phone Number_____________________________
Email _______________________________________ Email____________________________________
Tattoo or Microchip Number if applicable ________________________________________

I attest that the information supplied on this form is correct and that the dog was purchased directly from
the breeder (if breeder registering for owner(s), then breeder’s signature required instead of owner’s
signature).
Owner’s Signature _________________Co-owner’s Signature (if applicable)_______________________
Date _______________________________
Breeder’s Signature if Coton is to be registered as Potentially Breedable__________________________
In lieu of signature, breeder may send email to registry@cotondogs.com attesting that the Coton is Potentially Breedable.  If breeder is not available, please explain and provide breeder’s email address or phone number if possible.  Send application with appropriate fee to ACC, 3484 Waverley Street, Palo Alto, CA 94306

Note:  ACC is a Rare Breed club and intends to remain so.  In the event that the Coton de Tulear breed becomes recognized by the American Kennel Club, ACC will never share your pedigree information with AKC without your express written permission.