"*" indicates required fields EmailThis field is for validation purposes and should be left unchanged.Registration Application American Lineback Cattle Registry IncKalli Schwenk (717) 222-4943 alcr@americanlinebacks.com FOR OFFICE USE ONLYRegistration No*Date* MM slash DD slash YYYY Name*Name Choice - Please limit your choice to 30 characters or less including prefix and suffix (ET, TW or CL)If this animal is registered in another Registry, enter name of RegistryRegistration numberDate of Birth MM slash DD slash YYYY Birth Was Single Twin to Cow Twin to Bull Embryo Transplant If Embryo Transplant box is checked include Embryo Transplant Form with applicationSex of Animal(Cow | Bull | Steer)ColorHorn Status(Horned | Polled | Scurred | De-Horned)Tattoo (Left Ear)Tattoo (Right Ear)Herd ID Tag No. (Left Ear)Herd ID Tag No. (Right Ear)Herd ID Tag No. (Tag Color)RFID / EID No.State Metal Tag No.BrandLocation of BrandOther IDLineback Type White Classic Witrick Dark Sided Witrick Dark Speckled Witrick Gloucester Unmarked Lineback If animal falls somewhere in between these types, select the type that most closely resembles your animal. Please note any unusual markings.Please include 2 clear photos of each side of the animal being registered. Animal must be standing clearly showing side and legs. These photos will be printed on registration papers, showing the actual identity of the animal. One of the photos must show the face. We recommend that Digital Photos be emailed. Please email to: alcr@americanlinebacks.com (identify the animal in the photos)Parentage:If sire or dam is not registered, other ID must be used for identification - (RFID / EID or State Metal Tag No. is recommended).Name (Sire)Registration No. (Sire)Herd or Semen Code No. (Sire)Breed Association (Sire)Name (Dam)Registration No. (Dam)Herd No. (Dam)Breed Association (Dam)Dams Breeding Record:If animal is result of Artificial Insemination - attach all breeding receipts or report date of serviceIf animal is result of Natural Service please provide the dates which sire listed had access to dam: MM slash DD slash YYYY From dateIf animal is result of Natural Service please provide the dates which sire listed had access to dam: MM slash DD slash YYYY To dateOwner of Dam at time of Breeding: Owner NameMember No.Address Street Address City State / Province / Region ZIP / Postal Code Owner of Dam at time of Calving: Owner NameMember No.Address Street Address City State / Province / Region ZIP / Postal Code As recorded owner or authorized agent of the Dam of this animal at time of birth, (I / we) hereby certify that all information on this registration application is true and correct to the best of my knowledge, and that the ALCR Registry shall have the priviledge to correct and/or cancel this application under the Rules and Regulations of the Registry. By submitting this document, (I / we) hereby agree to be bound by the terms and conditions of the American Lineback Cattle Registry Inc.Owner/Agent SignatureMember No.Address Street Address City State / Province / Region ZIP / Postal Code Printed NamePhone Number (Home)Phone Number (Cell)Phone Number (Fax)E-mail Address* (Your e-mail address WILL NOT BE SHARED)
