New Member Application Form

New Member Application Form

Fill out the form carefully and completely. SICDTC Constitution & Member Incentives can be found on the Member Page on our website at www.sicdtc.org PLEASE NOTE: Membership dues to SICDTC 501(c)(4) organization are not deductible as charitable contributions.
Requirements for Membership Application:

1. Completed 2 sessions of 6 or 8 week classes at SICDTC

2. Attended 2 General Membership Meetings on Zoom or In-Person

3. Worked 2 hours for the club as a volunteer

If you have any questions, please contact our membership coordinator Geri Crane:

rallyregistrar@sicdtc.info
Type of Membership: May choose multiple membership options if applicable*

Individual Members (Primary): Adults, over 18 years of age. Membership may be individual or primary part of a family/same household membership. You are required to attend 4 meetings & work 16 hours (4Hrs at a trial) during the club year July 1-June 30.Junior Members: Members under 18 years of age. Upon reaching his/her 18th birthday, a Junior member may make an application for membership. Junior membership may be individual or part of a family/same household membership-Requirements for annual work and meetings waived, however membership requirements remain the same. Adult supervision required for classes/events.Family Member: May be added to a primary Individual membership and must live in the same household. NOTE: If a family member is also taking classes, that member is also required to complete the same work & meeting requirements.
LEGAL Name*

First NameLast Name
Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail *
example@example.com
Occupation*
Cell Phone Number *
Birthday -Month & Date (no year)
This is for our Birthday Greetings each Month. Skip to opt out
Junior Membership ONLY: Please Give FULL DOB including year

MonthDayYear
Date
Emergency Contact*

First NameLast Name
Emergency Contact Cell Phone Number*
Please enter a valid phone number.
#1 Dog's Call Name/Breed (if more space needed use comment box at the end)

NameBreed
#2 Dog's Call Name/Breed (if more space needed use comment box at the end)

NameBreed
Date of SICDTC Meeting Attended #1 *

MonthDayYear
Date
Date of SICDTC Meeting Attended #2*

MonthDayYear
Date
#1 Name of Class COMPLETED at SICDTC & Date (approx) *
#2 Name of Class COMPLETED at SICDTC & Date (approx)*
Dates and type of job worked -Must equal at least 2H*
Name of Board Member Sponsor (Confirmation will be sent by club for signature)*
Name of Member in Good Standing Sponsor ((Confirmation will be sent by club for signature)*
Name of Additional Family Member Living in Same Household Applying for Membership (if applicable): may use comment box for additional members

First NameLast Name
Cell Phone Number
Please enter a valid phone number.
Email
example@example.com
As a member, you are required to work 16hours /club year (July-June) 4H must be at a Trial. Please indicate which jobs would be of interest to you.*

Trial Jobs-Clean &/ or Set-up-Agility. Rally, Obedience, Nosework, FastCATTrial Jobs-Hospitality- Agility, Rally, Obedience, Nosework, FastCATTrial Jobs-Agility Ring Steward/Leash Runner/Score RunnerTrial Jobs-Agility Course BuilderTrial Jobs-Rally/Obedience Ring StewardTrial Jobs-Rally/Obedience Table Steward (Timer, Scorer, Gate)Trial Jobs-Rally/Obedience Trial Secretary PoolTrial Jobs-FastCAT Steward, Check-inTrial Jobs-Nosework Steward, Timer, Check-inMatch Show-Table/Ring StewardsOther (add in comment box below)
The primary applicant and additionally added applicants, agree(s), upon admission to membership, to read and abide by the Constitution and By- Laws of Staten Island Companion Dog Training Club, Inc. (After submission you will be redirected to the SICDTC member page where you can find Constitution and other membership information)
Primary Member Please Sign Below*

Clear
Optional: Tell us something about yourself to help us know you better. Why do you want to join this club? Add Additional Notes/Comments
Membership Fees: Payment must be submitted with application. If you have trouble submitting payment with this form please send email to Desma at SICDTC@hotmail.com*
prevnext( X )
Individual Primary Membership Fee
$45.00



Individual Junior Membership
$45.00



Family Membership Fee Must include 1 Individual Membership. Family Member must live in same household (see Constitution on website for more details)
$5.00 Quantity



Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty: