AMCUK Membership Renewal

Chesapeake Irish Terrier Club Membership Renewal 2023

Please use this form if you wish to pay for your membership renewal by Online Payment
Thank you for renewing your CITC Membership for 2024.

Please ONLY complete this form if you wish to pay using PayPal or Zelle.

If you intend to pay by cheque or cash, please use a hard copy form and send it along with payment to the Membership Secretary:

Robert Fry

19397 Hundred Acres Ln

Leesburg, VA 20175

By completing this form you are agreeing to abide by CITC Rules and Code of Ethics (https://www.chesapeakeitc.com/Documents/CHESAPEAKE_IRISH_TERRIER_CLUB_CODE_OF_ETHICS_2014.pdf).

Thank you.
Full Name (Member 1)*

First NameLast Name
Full Name (Member 2)

First NameLast Name
Full Name (Member 3)

First NameLast Name
KC Kennel Name
Affix - If you have one
E-mail*
Phone Number

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState

Zip Code

Chesapeake Irish Terrier Club Membership Renewal 2023