Litter Registration Form

DON'T USE THIS FORM UNLESS YOU ARE FAMILIAR WITH OUR FAQ AND REGISTRATION PROCEDURE!

Please fill in the online form below to request a Litter Certificate which we will send to you once all requirements are met. When you sell your piglets, provide a copy of the certificate to each customer, indicating which piglet(s) they purchased. Then instruct the customer to send it to us to register their pigs. If you are registering them for yourself or your customers, complete one hog registration form (above) for each pig in addition to the Litter Certificate form.

If you just want to give us a birth notification (not sell any piglets as registered or registerable) there is no fee. Birth notifications help us keep information on the proclivity of the sows and total number of Large Black hogs born each year. This information is very important to gauge the health of the breed, so please report your litters to us!

Please fill in the sex of each surviving piglet from the litter. The sequence must correspond to the ear notches of the piglets.

* Is this for a Litter Certificate or Birth Notification?

Litter Certificate

Birth Notification

* Breeder's Farm Name or Individual Name

* Litter Number for this farm

* Sire's Registered Name and Number (Registration Format)

* Dam's Registered Name and Number (Registration Format)

Attach copies of the Boar and Dam's Registration Certificates.

* Date of Birth

* Number of live births

* Number stillborn

* Number of surviving males

* Number of surviving females

* Type of certificate desired

Email

Paper

Both

None

Sex of Piglet notched "1"

Sex of Piglet notched "2"

Sex of Piglet notched "3"

Sex of Piglet notched "4"

Sex of Piglet notched "5"

Sex of Piglet notched "6"

Sex of Piglet notched "7"

Sex of Piglet notched "8"

Sex of Piglet notched "9"

Sex of Piglet notched "10"

Sex of Piglet notched "11"

Sex of Piglet notched "12"

Your information

* First Name

* Last Name

* Address 1

Address 2

* City

* State

* Postal Code

* Phone

Email Address

Comments

0/200 characters

The fee for a Litter Certificate is $5.00 (U.S.) Birth Notifications are free.

Please remember to pay for this registration on our "PayPal Forms" page.

If you choose to pay by check, please make it out to "LBHA" and mail it to:

LBHA

c/o David Dalan

PO Box 3325

Walla Walla, WA 99362

* Indicates Response Required