British Miniature Horse Society
Transcription
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):