Official Registry for the Gypsy Vanner Horse est. 1996

First Name:*
Last Name:*
Telephone:*
Email address:*
Farm Name:*
Mailing address:*
Breeder Name, State/Country: (the owner of the dam at time of foaling is considered to be the breede:*
Horse Information
Name of Horse:*
Date of Birth:*
Country of Birth:*
Date of importation if applicable:
Choose one:	Stallion Mare Gelding
Choose all that apply:	Black and White Red and White Bay and White Gray and White Gray Blagdon Black Bay Palomino Chestnut Buckskin Other
use this space to explain:*
Check this box if this horse is a result of Embryo Transfer:	.
Sire / Sires Reg #*
GrandSire (Sire side) / Reg #*
GrandDam (Sire’s side)/ Reg #*
Dam / Dam’s Reg #*
GrandSire (dam’s side) / Reg #*
GrandDam (dam’s side) / Reg #*
Additional pedigree information or other info we should have:*
I will pay the registration fee by (select one)*
Verification No.:*