DPCA Chapter Club Renewal

DPCA Chapter Club Renewal
Chapter Club Name *
Email of club member to receive renewal verification *
example@example.com
All Chapter Club officers and delegates MUST be a DPCA member or have applied for DPCA membership within 30 days of election.
Delegate Name *

First Name Last Name
Delegate Address *

Street Address

Street Address Line 2

City State

Zip Code
Delegate Email
example@example.com
Delegate Phone *
Please enter a valid phone number.
All Chapter Club officers and delegates MUST be a DPCA member or have applied for DPCA membership within 30 days of election.
Secretary Name *

First Name Last Name
Secretary Address *

Street Address

Street Address Line 2

City State

Zip Code
Secretary Email
example@example.com
Secretary Phone *
Please enter a valid phone number.

Employer Identification Number
Group Identification Number
Did your club have annual gross receipts of more than $25,000 during this past year? (Clubs with gross receipts in excess of $25,000 are required to file Form 990with the IRS) *

Yes No
Is your club currently active? *

Yes No
Has there been any change in your club’s purpose, character, or method of operation? *

Yes No
Please explain the change in your club’s purpose, character, or method of operation.

All Chapter Club officers and delegates MUST be a DPCA member or have applied for DPCA membership within 30 days of election.

Officer Information *

Name

Date Elected

For Year Of

DPCA Member

President

Treasurer

Recording Sec.

Alternate Del.

Amount Due *

Amount Due

Annual dues

Health/Research

Rescue

Judges Education

General Fund

Juniors

In as much as our parent organization, Doberman Pinscher Club of America, has included us in a 501(c)(3) group exemption recognition before the IRS,we acknowledge our responsibility to make annual information reports pertaining to our continued good standing. We further agree to adhere to their specific policies related to the 501(c)(3) status which in their judgment keep this status well maintained. While we reserve the right to challenge any such policy that may be established, we will inform them of such action in writing 30 days prior to any implementation on our part.Dues are payable upon receipt of notice. Membership will be automatically terminated if dues are not received by January 31, 2021. Dues must be postmarked by December 31, 2020 for member club to be eligible to participate in any parent club business conducted in January 2021.

Pay for Chapter Club Renewal

USD Description

Payment Method