Hmong Bobtail Club of America

Hmong Bobtail Club of America

Membership Form
Full Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
E-mail
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

If you are applying as a household please add additional member names, relevant address, and contact information. Please include whether each member is applying as a Breeder, Owner, Exhibitor, or Judge.

Rows	Full Name	Address	Contact Number	Status
1
2
3
4

Additional Information
Briefly describe your experience and involvement with the breed
Do you own at least one Hmong Bobtail that you want registered with the club or own at least one Hmong Bobtail that is currently registered with the club?

Other
Please check all that applies to you

Other
Submission (via PayPal to Hmongbobtail@gmail.com)
Are you over the age of 18?
I understand that this application will hereby apply me for membership with the HBCA upon submission and that I agree to the club’s Constitution, Bylaws, and Code of Ethics.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parties involved agree that this agreement may be electronically signed and that the signature here is the same as a handwritten signature for the purpose of validity, enforceability and admissability.

If you do not wish to apply and sign digitally, you may download, print, sign and scan a paper copy of the membership form to be sent to hmongbobtail@gmail.com instead.
Signature
Should be Empty: