Interested in Becoming a Chintimini Kennel Club Member?

To be eligiable to become a member, candidates must attend at least 1 club meeting or volunteer at a CKC sponsored event prior to submitting their application. A paper copy of the Application Form with signatures by club members sponsoring you application must be submitted to the Club Secretary before a membership vote can be taken. Membership vote is held after the reading of the application at the next club meeting.

Payment of Membership Fee is required

Name *

First Name Last Name

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Email *

Confirmation Email example@example.com

Applicant Phone Number *

Please enter a valid phone number.

Type of Membership: *

Individual (voting $10) Household (2 adults, voting $15) Associate/Junior (non-voting $5)

Number of Years in Purebred Dogs *

Number of Litters in last 3 years *

Please list dog breed(s) you have owned (past and present; enter "none" if appropriate): *

Please list other dog club affiliations and any offices held with each club *

I (we) am (are) interested in: *

Conformation Obedience Rally Agility Pet Breeding Field Event Lure Coursing

Other Interests in addition to above? *

Why do you want join Chintimini Kennel Club? *

List member's of Chintimini Club that can sponsor you membership *

Have you volunteered at a Chintimini Kennel Club AKC Sponsored Event? *

Yes No

Date of the Event

Date

Name of Event

List Any Other Events

Have you ever been suspended by the AKC or any other dog club? *

Yes No

Have you ever been cited by the SPCA, any humane society or animal control organization? *

Yes No

Have you at any time been associated with, or sold dogs to, a wholesale or retail canine operation? *

Yes No

Please Explain any Yes answers to the above three questions. *

I agree to have meeting notices and other club notices sent by email rather than through the post office, *

Yes No

I (we) have answered these statements honestly and I (we) certify that I (we) am (are) in good standing with the American Kennel Club. I (we) agree to abide by the rules and regulations of the American Kennel Club as well as the Constitution and Bylaws of the Chintimini Kennel Club (CKC).

Check this box to indicate that this statement is true *

This Statement is True

Membership Fee

Fee Payment *

USD Description

Credit Card