British Miniature Horse Society

British Miniature Horse Society
Stretcholt Farm, Stretcholt, Bridgwater, Somerset, TA6 4SR
Application for Registration/Passport
(Please refer to the Application Pack, or the BMHS website for instructions). The last 2 sections – ‘Section I
Part A’ and ‘Section I Part B’ – must only be filled out by a qualified veterinarian.
I wish to apply for (please tick appropriate box):
-Registration Only
-Passport Only
-Registration and Passport
(This horse already has
a valid passport, copy of Sections I,
II, and V is attached)
(This horse does not already
have a passport)
(This horse does not already
have a passport)
Name of Horse (not to exceed 30 letters):
................................................................................................................................................................
Height at withers ……………….cm
Date Measured (dd/mm/yyyy) ..…../……/……
Sex (m/f/g) ………….
Date of Birth (dd/mm/yyyy) .……/….…/……
Colour of Body ………………………..
Mane & Tail .…………………………………….
Distinguishing Markings ……………………….………………………………………………..........
Name of Sire:
BMHS Reg. No.:
Height (cm):
Name of Dam:
BMHS Reg. No.:
Height (cm):
Owners Name:
Breeders Name:
……………………………………………
……………………………………………
Address:
……………………………………………
Address:
……………………………………………
……………………………………………
……………………………………………
……………………………………………
……………………………………………
Postcode: …………………………………
Postcode: ………………………………...
Tel No: ……………………………………
Tel No: ……………………………………
Owners Signature*: …………………………………………………………………………….
*By signing this form, I agree that the information that I have supplied within this document is, to the best of my knowledge, true and correct.
I also consent to the British Miniature Horse Society’s ‘Passport & Registrations: Terms & Conditions’ and ‘Privacy Statement’ (both available
upon request or in the ‘Downloads’ section of our website – www.bmhs.co.uk
SECTION I Part/Partie B – Outline Diagram/Signalement graphique d’identification
Mark on the diagram with a ‘M’ where microchip is implanted.
13. Left side / Côté gauche
12. Right Side / Côté droite
14.
Upper
Eye Level
Ligne
supérieure
des yeux
15.
Hind Rear View
Postérieurs Vue
postérieure
SECTION I (Part/Partie A) – Identification
Left
Gauche
e
Right
Droit
16.
Neck Lower View
Encolure Vue
inférieure
18.
Fore Rear View
Antérieurs Vue
postérieure
Left
Gauche
Right
Droit
Name / Nom:
Transponder Code (where available):
Code du transpondeur (si disponible)
BAR-CODE / CODE-BARRES
Signature and stamp of veterinarian or qualified person or competent Authority (name in capital letters)/Signature et cachet du vétérinarie ou de la personne qualifiée ou de
l’authorité compétente (nom en lettres capitales) :
SECTION I Part/Partie A – Identification Details/Données d’identification
Species / Espéce:
Sex / Sexe:
Colour/Robe:
Date of Birth / Date de naissance:
Name and Address of the person to whom the
document is issued / Nom et adresse du
destinataire du document:
Description/Signalement:
Markings/Marques:
Head / Tête:
Foreleg Left / Ant. Gauche:
Foreleg Right / Ant. Droite:
Hindleg Left / Post. Gauche:
Information on any other appropriate method
guaranteed to verify the identity of the animal
(blood group / DNA Code) (Optional) /
Information sur toute autre méthode
appropriéedonnant des garanties pour vérifier
l’identité de l’animal (groupe sanguin / code AND)
(optionnel):
Hindleg Right / Post. Droite:
Body / Corps:
Alternative Method of Marking (if available) / Méthode de marquage alternatuve (si
disponible):
Description taken with Dam by:
Full name of Dam:
UNIQUE LIFE NUMBER (UELN)/Numéro unique d’identification valable à vie:
Reading System (if not ISO 11784) / Système de
lecture (si différent de ISO 11784):