BMDCW Renewal Membership Application Form

BMDCW Dues Renewal Notice

Due by March 1
Name*

First NameLast Name
Address*

Street Address

Kennel Name (if applicable)

CityState / Province

Postal / Zip CodeCountry
E-mail*
example@example.com
Website
Occupation(s)
Home Number
Cellular Number*
Work Number
Are you interested in participating in the BMDCW Group E-mail list?

YesNo
Would like to receive the newsletter electronically?

Electronic (Free)Mail ($10 Fee)
Please check off all interests:

BreederConformationObedienceRallyAgilityService
DraftHerdingTrackingPet TherapyBarn Hunt
If you have any comments, ideas or suggestions please provide them below.
Membership Options*
prevnext( X )
Regular: First adult member in household(Non-Voting) (Voting privileges granted after 2 years with 2 sponsors)
$25.00



Senior Membership (over age 60)Please provide a copy of your driver's license, passport or birth certificate - one time only)
$20.00



Each additional member in same household
$5.00



Receive Mailed Copy of Newsletter
$10.00



Would you like to make an additional contribution to Club Funds?(ie: Rescue Fund, Trophy Fund, General Club Fund)
$25.00



Paypal Service FeePlease check this if you're going to pay via the Paypal link below. No service fee if you're sending a check (info below)
$2.00



Total

$0.00
Please consider helping with club activities - remember this is your club ... Are you willing to help with Club activities?

YesNo
With the view to the betterment of the breed of dog known as the Bernese Mountain Dog, I agree to abide by the rules and regulations of the American Kennel Club and the Constitution and Bylaws of the Bernese Mountain Dog Club of Watchung, Inc.

BMDCW Code of Ethics
Signature*

Clear
Date

MonthDayYear
Date
Signature

Clear
Date

MonthDayYear
Date
Signature

Clear
Date

MonthDayYear
Date
This application may take several weeks to process. Depending on how late in the year your application is made, your dues may be applied to the next calendar year.

If you have any questions please reach out to Heidi Henderson BMDCW Membership Chair

Cell: (201) 310-9346

Email: snowpawbmd@gmail.com

If you would like to mail your Membership fee please send your check to:

Heidi Henderson: 376 Coffeehouse Rd., Killington, VT 05751

If you'd like to pay via Paypal please click the link on the next page after you Renew Membership below.

Thank you Very Much!!
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BMDCW Dues Renewal Notice