MGA Membership Form

Michigan Gazehound Association (MGA)

Membership Application/Change of Information

Please send your membership dues using the form below.

ELIGIBILITY. Regular membership is open to all persons 18 years of age or older, who are in good standing with the AKC and ASFA, and who subscribe to the purposes of the club. Junior membershipis open to children under the age of 18, which automatically converts to regular membership at age 18.

VOTING PRIVILEGE. Regular membership includes the right to vote and hold office.

DUES. Annual dues are $5 for a Junior membership, $10 for a Single regular membership, and $15 for a Household (two regular memberships)-payable by January 1 each year. Dues paid after September 30 are carried into the next calendar year. Multiple years can be paid for at once.
Name *
Single member
Phone Number
Please enter a valid phone number.
EMAIL*
example@example.com
Name
Household add'l member
Phone Number
Please enter a valid phone number.
EMAIL
example@example.com
ADDRESS
Street
City
State/Zip
Breeds Own(ed)
Dog Club Affiliations
What jobs have you done in the past at coursing trials? List all jobs
What aspects or jobs of coursing (at trials and within the club) are you interested in learning?
What life skills / experience (both coursing and non-coursing) do you have that you feel could be useful to MGA?
The above information is given in consideration of my application for membership in theMichigan Gazehound Association, Inc
Signature

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Signature

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Include check made payable to MGA or pay via paypal.

Renewals are due January 1st.

If mailing, please send this form and check to:

Cathy Kirchmeyer, MGA Treasurer, 20207 Southwick Rd. Milan, MI 48160

Submitting this electronically will send the form without having to mail.
For new members, please choose new (1 yr). For renewals you can pay for up to 3 years in advance
prevnext( X )
Junior New Memebr New (1yr)
$5.00



JuniorRenewal
$5.00 Quantity



Single New MemberNew (1yr)
$10.00



SingleRenewal
$10.00 Quantity



Household New Members
$15.00



HouseholdRenewal
$15.00 Quantity



Lifetime Member
$ Free



Update information only
$ Free



Total

$0.00
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ADDRESS