Please read all instructions carefully. Complete this form in ink or type written. A delay in processing will result if application is not complete.
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1 Appaloosa Horse Club of Canada Application for ApHC to ApHCC Pedigree Registration Box rd Street S.E. Claresholm, AB T0L 0T0 (403) Fax (403) Please read all instructions carefully. Complete this form in ink or type written. A delay in processing will result if application is not complete. Four (4) photographs MUST be submitted: direct front view, left side profile view, right side profile view, and direct hind view. Photographs must be clearly labeled on the back of each photo with the name of the applicant horse, date of photo, and name and address of the person taking the photo (refer to Bylaws, Section XII E.). The certificate for this horse will be issued in accordance with the photographs submitted. Polaroid, digital, or computer generated photographs will not be accepted.! No! Yes The applicant horse is a descendant of Impressive # AQHA. HYPP testing is required OR required documentation is attached (refer to Bylaws, Section XI C and contact ApHCC for procedures).! No! Yes The applicant horse was conceived using transported or frozen semen or is an embryo transfer foal. If so, parentage verification is required. Contact ApHCC for procedures and forms prior to initiating parentage verification procedures.! No! Yes I authorize the ApHCC to name the applicant horse if my name choices are in use or not acceptable. NAME: NOTE: This horse shall be registered with the name recorded on the ApHC certificate for identification purposes, the ApHC registration number will be recorded on the back of the ApHCC certificate. If the name has previously been used, it will be registered with the second name choice, and the ApHC name and registration number will be recorded on the back of the ApHCC certificate. Provide two [2] name choices, not to exceed 20 letters including punctuation and spaces. 1st 2nd Foaling Date: Month Day Year Foaling Location: City Province/State Sire: Name Certificate # Association SEX:!Stallion!Mare!Gelding Dam: Name Certificate # Association As the owner of this horse named above (or recorded authority of the owner[s]), I hereby certify that all of the information on this application form is true and correct and agree that the Appaloosa Horse Club of Canada has the right to correct and/or cancel the certificate for causes under its Constitution, Bylaws, Regulations, and Rules. By submission of this Application for Pedigree Registration to the ApHCC, the owner(s) of the sire, dam, and/or applicant horse agree to make arrangements and make these horses available for DNA typing and parentage verification or genetic testing, should the horse require testing pursuant to the Constitution, Bylaws, and Regulations of the ApHCC, including but not limited to the random parentage testing program. If the beneficial owner of the property named in this document is under the age of majority in the province of residence of the named beneficial owner, a trustee must be named as the owner/applicant/purchaser in the designated area of this form, as, for example Elaine Smith, trustee James Smith (parent). Print Name(s) of owner of applicant horse: ApHCC Membership # Address: Phone Number Signature(s) of owner(s), lessee, or authorized agent of owner of applicant horse: X Date signed: FR1-2 (01-02) INSTRUCTIONS 1. Complete this form in ink or type written. The ApHCC Inspector/Veterinary Evaluation form must be completed for this application. A delay in processing will result if application is not complete. 2. Cheque, money order, Visa or MasterCard payment for the amount due shall be included with this application. The total amount due for Rush Orders shall be paid by money order, Visa or MasterCard.
2 INSTRUCTIONS (continued) 3. When completing the written description and the diagram of face/leg markings, familiarize yourself with the definitions included in Appendix A and B of the ApHCC Official Handbook. 4. Photographs must confirm the markings recorded on the Inspector/Veterinary Evaluation Form. If a marking is not visible in the photographs submitted, or if there appears to be a marking visible in the photographs but not recorded on the application form, you will receive a request for additional photos. These additional photos will be required before the Registrar may consider issuing a certificate for the applicant horse. 5. APPENDIX C - APPLICATION FOR ApHC (USA) HORSES FOR ENTRY INTO THE ApHCC BOOK OF IDENTIFIED APPALOOSAS ApHC horses may apply for identification in one of the four (4) Levels of Identified Appaloosa Horses. The following procedures must be followed: An Application for ApHC (USA) to ApHCC Book of Identified Appaloosas must be completed and signed by the owner. A copy of the front and back of the ApHC (USA) certificate must be submitted to the ApHCC with the Application. 1. A Veterinary Doctor or ApHCC Inspector must complete an ApHCC Inspector/Veterinarian Evaluation Form supplied by the ApHCC. This form shall require information on the height of the horse, whether the horse is monorchid or cryptorchid (stallions), whether the horse has an overbite or underbite (stallions and mares) and/or other information as may be required by the ApHCC By-Laws including SECTION XII.E The owner shall submit at least four (4) current, colour photographs of the horses and all information as in the ApHCC By-Laws. This shall include complete left and right side views, direct front view, direct rear view, showing all face markings, leg markings, brands, scars and Appaloosa coat pattern and/or characteristics [SECTION XII E.1]. 3. The Application for ApHC into ApHCC Book of Identified Appaloosas and the Inspector or Veterinary Evaluation Form and the current colour photographs will be examined by the ApHCC Registrar. The pedigree of the applicant horse will also be evaluated to determine the lineage of ancestry (SECTION VII.C.2). All applications shall be subject to the determination of all parts of the evaluation. 4. The horse must have at least one parent registered/identified with the Appaloosa Horse Club of Canada or with the Appaloosa Horse Club, Moscow, Idaho. The other parent can be one of the following crosses: i) The Appaloosa Horse Club of Canada, Register of Appaloosa Horses ii) The Appaloosa Horse Club, Moscow, Idaho iii) The American Quarter Horse Association, registered or appendix certificate, Amarillo,Texas iv) The Canadian Quarter Horse Association v) The Jockey Club (Thoroughbred), Kentucky vi) The Canadian Thoroughbred Horse Society The characteristic Appaloosa, CPO Appaloosa, no characteristic Appaloosa, registered Quarter Horse, or registered Thoroughbred horse must be bred to an Appaloosa horse as described above which has a recognizable Appaloosa coat pattern, other than solid. 5. Regardless of the sex of the horse, its parents must meet all the requirements herein referred. 6. If the recorded owner at the time of application is not the recorded owner on the ApHC (USA) certificate, a transfer of ownership must be signed by the last recorded owner(s) and must accompany this application. 7. Any horse registered with the ApHC (USA) and owned by a resident of Canada, must be registered with the ApHCC before the horse may be shown at ApHCC approved shows and before that horse s progeny are qualified for registration with the ApHCC. 8. By submission of this Application, the applicant certifies that all information on the application is true and correct, and agrees that the Appaloosa Horse Club of Canada has the right to correct and/or cancel the certificate for causes under its Constitution, Bylaws, Regulations and Appendices thereto, and agrees to make the applicant available for or DNA typing and parentage verification should the applicant horse be chosen for testing pursuant to the Constitution, By-laws, and Regulations, of the ApHCC and specifically the random parentage testing program (Regulations Part 2:). REGISTRATION FEES All Fees Subject to Change A. Pedigree Registration Fees Member Non-Member Until 31 December 2003 ApHC or other foreign registry to ApHCC!$53.50 $26.75!$ $53.50 ApHCC Inspector/Veterinary Evaluation to accompany this application. ApHCC Inspector/Veterinary Evaluation forms are available from the ApHCC. B. Rush Application The above Fee and your choice of the following Rush Fees MUST be paid by Money Order, Visa, MasterCard, or certified cheque. Rush fee includes XpressPost postage. 10 Office Day Rush!$32.10!$ Hour Rush!$53.50!$ C. Mailing Options All documents are automatically returned by Canada Post First Class Mail or customers may choose from the following options:! $10.70 XpressPost fee included OR!Residents of BC, AB, SK or MB! Residents of ON, PQ Atlantic, NT or YK include a Prepaid Regional Letter Size include a Prepaid National Letter Size XpressPost envelope XpressPost Envelope D. Membership Fees Adult Membership!$37.45 Membership may be purchased at time of Youth Membership!$21.40 transaction to allow benefit of Members Family Membership!$53.50 fees. Family Membership is designed for persons living as a family with the same principle address. The Family Membership includes a maximum of two Adult members, (one to be designated as a voting member) and youth 18 years and younger as of January first of the current year.! Cheque! MoneyOrder! MasterCard! Visa Credit Card # Expiry Date Card holder s name: Card Holder s Signature: 2-01)
3 ApHCC INSPECTOR or VETERINARIAN EVALUATION FORM Return to: ApHCC, Box 940, Claresholm, AB T0L 0T Name of Horse: Certificate # if registered: Owner Name & Address: Sex: " Stallion " Mare " Gelding " Spayed Mare PHYSICAL IDENTIFICATION Base Color (circle color): Bay/Dark Bay Red Roan Dun Palomino Brown Blue Roan White Grulla Black Bay Roan Grey Buckskin Chestnut Provide complete written description of markings and location of markings. Outline all markings on attached diagram. Face Markings: Left Fore Leg: Right Fore Leg: Left Hind Leg: Right Hind Leg: Unusual Marking or Color: Color of Mane & Tail: Notable Scars: Brands: Freeze Marks: Tattoo: Micro-chip: Glass or Blue Eyes: " Left Eye " Right Eye " Both Eyes
4 THE BREED STANDARD 1) YES NO Is this horse of light horse body type; free of draft horse or pony body types. If NO, please explain: 2) Height Give the of this horse at the withers (unshod) 3) Coat Patterns (circle pattern): Blanket Leopard Roan Blanket Varnish Roan Blanket with Spots Spots Roan Blanket with Spots 4) Other Apparent Characteristics (circle characteristics present): Mottled Skin: Muzzle Udder Sheath Anus Vulva White Sclera: Left Eye Right Eye Striped Hooves: Left Fore Right Fore Left Hind Right Hind Other 1) Inches or Centimeters: Circumference of the Cannon Bone (measured at the smallest place on the cannon bone of a front leg. Circumference between the fetlock joint and the knee) 2) Yes NO Is this horse monorchid or cryptorchid? If Yes, please explain: 3) Yes NO Does this horse have an overbite or underbite of over ¾ s of a tooth? If YES, please explain: 4) What is the age of this horse? Inspector or Veterinary Doctor Information Name of Inspector or Veterinary Clinic: Phone Number: Date and Location of Evaluation: Print Name of Inspector or Veterinary Doctor: Signature of Inspector or Veterinary Doctor:
5
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