Section I - Highland Pony Society

The Highland Pony Society
APPLICATION FOR PASSPORT
Please enter names and numbers carefully and neatly in BLOCK CAPITALS and complete the outline diagram and narrative
describing the whorls on the reverse, which will be photocopied and inserted in the passport. Animals must be microchipped if the
animal has never had a passport and the bar code label affixed on the reverse side.
NB: the veterinary surgeon inserting the transponder (microchip) must complete the relevant sections on the right of the reverse
side.
Name: ………………………………………………………………………………………..……………………….
YES / NO Please delete as appropriate
Is this pony registered with the Highland Pony Society?
/
If yes, please give Stud Book Number ........................................................................... .e.g. PB123/09
If this pony is not registered with the Highland Pony Society, is it of ‘HIGHLAND TYPE’?
Registered
Part Bred
Unregistered



YES / NO Please delete as appropriate

Filly/Mare
Eel Stripe Yes

Colt
Eel Stripe No

Gelding
(Please tick as appropriate)
Date foaled: (dd/mm/yyyy) ____ / ____ / __________
Office Use


Member
Non-member


Applicant’s
Signature

Registered

Unregistered

Reverse
Barcode Label

Vet Signature

Appl’s Sig

Whorls

ALL OK

Colour: …………………………………………...
Include markings below. (Whorls should be described on the reverse side only).
Body ……………………………………………………………………………………………………
Forelegs ……………………..…….…………………………………………………………………..
Fore Hoofs ………………………………………………………………………………....................
Hind legs ………………………………..……………………………………………………….…….
Hind Hoofs ……………………………………………………………………………………............
G.Sire ……….………….…….…………...
Reg. No …...……..
Sire ……………….……….......................
G.Dam ……………….………….………..
G.Sire ………………..……………….…...
Reg. No ………….
Dam …………………………...…….........
G.Dam ……………………………….……
Name(s) of Breeder(s): ………………………………………………………………………..……………..……..
Address:
…………………………………………………………………………………………………..……
………………………………………………………………...
Telephone: ……………………...
Mobile: ………………..
Postcode: ………….………..
email: ………………………………………...
If form has to be returned due to errors or omissions an administration fee may be charged.
I/We hereby declare that I/we bred the above animal and the foregoing particulars are true to the best
of my/our belief and knowledge.
Signature(s) of Breeder(s): ………………………………………………………..……… Date: …………….
Fees:
Duplicates Passport - £20
Passports for ponies of Highland Type - £20
Cheques payable to “THE HIGHLAND PONY SOCIETY”
Mrs Susie Robertson (Secretary)
Highland Pony Soc ety
Grosvenor House
Shore Road
Perth PH2 8BD
Tel/Fax: 01738 451861
Email: [email protected]
Section I
Part A – Identification Details
Name of Pony:
Unique life number-UELN: (Numéro unique d’identification valuable à vie)
(Nom)
826 031 20 ___ ___ ___ ___ ___ ___ ___
Species: (Espèce)
Horse / Pony
Description
Sex: (Sexe)
Date of birth:
/
Transponder code:
(Date de naissance)
/
dd/mm/yyyy
(Code du transpondeur)
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __
Affix transponder barcode label here: (Transpondeur apposer l'étiquette de
code barre ici)
(Signalement)
[ Barcode label here ]
Foal Colour: (Robe)
Adult Colour: (Robe)
Head:
Reading system-if not ISO 11784
(Tête)
(Système de lecture-si different de ISO 11784)
Alternative method of marking (if available)
(Méthode de marquage alternative (si disponible))
Information on any other appropriate method providing guarantee to verify
the identity of the animal (blood group / DNA code-optional). (Information sur toute
Body: (Corps)
autre méthode appropriée donnant des garanties pour vérifier l’identité de l’animal (groupe
sanguine/code ADN-optionnel))
Name (in capitals) and signature and stamp of qualified person or
competent authority (who inserted the transponder): (Nom (en
capitales) et signature et cachet de la personne qualifiée ou l’autorité compétente)
Neck:
Name: (nom) ____________________________________________
(Encolure)
District:
Left Foreleg:
(Ant G)
(Circonscription) ______________________ Date: _________
Signature: __________________________________
Right Foreleg:
Stamp:
(Ant D)
(Cachet)
Left Hindleg:
Name and address of person to whom document is issued
(Post G)
(Nom et adresse du destinataire du document)
Right Hindleg:
(Post D)
Markings:
(Office use only - Affix label here)
(Marques)
Signature: (Breeder or Inspector)
Date:
↑↑↑↑↑↑↑↑↑↑↑↑↑↑↑↑↑↑↑↑
↑↑↑↑↑↑↑↑↑↑↑↑↑↑↑↑↑↑↑↑
Breeder to complete this section and sign and date
Transponder inserter to complete relevant non-shaded areas
Hair whorls to be marked X in Black ink – White markings to be sketched in Red ink
↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓↓
d
Note location of
Section I
Part B – Outline Diagram
Transponder
with (m)
Right Side
Left Side
Côte droit
Côte gauche
Upper eye level
Ligne supérieure des yeux
Fore-Rear view
Hind-Rear view
Antérieurs vue
postérieure
Postérieurs vue
postérieure
Left
Right
Gauche
Droit
Neck – Lower view
Encolure vue inférieure
Muzzle
Left
Right
Nez
Gauche
Droit