Membership Form

Peninsula Dog Fanciers' Club, Inc.

Full Membership Application
Adopted March, 2023

Full Membership is available to anyone who has completed the requirements for Associate Membership and would like to have a voice in the Leadership of the club. A Full Member is included in the quorum, has the privilege to vote and hold an Office or Position on the Board.
Dues: $11.00 (includes $1.00 online processing fee)
Name:*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone:*
Please enter a valid phone number.
Cell Phone:
Please enter a valid phone number.
Email:*
example@example.com
Please indicate any dog sports you are currently involved in:

ConformationObedienceRallyScentworkAgilityFlyballEarthdogLure CoursingBarn HuntUpDogField SportsFastCatTrackingFit DogOther
Would you be interested in being part of a Committee/Team?

YesNoNot at this time
If so, which Committee/Team(s) interest you:

MembershipBreed ShowSeminarsMediaCommunity OutreachHospitalityScentwork TrialEquipmentFit DogSunshinePerformance WeekendPublic EducationNominationConstitution/Bylaws/Standing Rules ReviewCommunity Service ProjectOther
Are you interested in being on the Board or holding an Officer position:

YesNoNot at this time
May we share your information with other club members?*

YesNo
Club Agreement:*

I agree to abide by the Peninsula Dog Fanciers' Club and AKC Rules, Regulations, Policies and Guidelines.
Signature:*
(Typing your name in this box constitutes a signature)
Date*

MonthDayYear
Date
*
prevnext( X )
Full Membership
$11.00 for each year
For Club Use:
Payment Method:

CashCheckOnline
Copy sent to:

SecretaryTreasurerPresident
Membership Chair Initials
Date
Should be Empty: