Auckland Beagle Club Membership Form

Auckland Beagle Club Membership Form
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
Phone Number
Kennel Name
(name of the kennel who bred your dog)
Beagle(s) Name(s)
Select a payment option (Annual Membership $20)*

Online BankingCash
Online Banking
- Account number: 03-0239-0089238-000
- Account name: Auckland Beagle Club
- Payment reference: Use the surname/last name of member above
Cash

Please put the cash in an envelope with the member's name clearly written on it. Find Ray or another committee member at the next club walk and they can pass your payment on to Shane.
Club Agreement*

I/We agree to abide by the rules set down by the club - a copy of the Club’s Constitution will be sent to all new members
Please verify that you are human*
Should be Empty: