HMBMDC Application

HEART OF MICHIGAN BERNESE MOUNTAIN DOG CLUB, INC.

NEW MEMBERSHIP APPLICATION
Please complete one application form for each primary membership application. Secondary memberships may use the same form as the primary if applying at the same time. Please remember to include the $4.00 application fee with this application form.
Name (Primary Member)
Name (Secondary Member)
Address
City, State, zip
Occupation
Email Address
Phone Number
Personal Website
DUES SCHEDULE

Application Fee (one per application form) $ 4.00

Primary Adult Membership Fee (one adult) $25.00

Secondary Adult Membership (same household) $12.50
Children under 18 are welcome to attend meetings and events with their parents and dogs at no additional cost. If your child wants to become a member we have a separate Junior Membership application form for those under 18 who are interested. Do you own Bernese Mountain Dogs?

Not YetYes
If YES, since?
What is/are your dog's call name(s)?
Registered name(s) (optional)
Are you a member of the Bernese Mountain Dog Club of America?

Primary - YESPrimary -NO
Secondary?

Secondary - YESSecondary - NO
Are you a breeder of Bernese Mountain Dogs?

YesNo
If YES, What is your Kennel Name?
Date of Last Litter whelped

MonthDayYear
Date
As a breeder what do you hope to achieve by being a member of the HMBMDC?
Do you participate in BernerGarde?

YesNo
Have you attended any HMBMDC event in the past year?

YesNo
If yes which one(s), and when?
Why do you want to join our club?
We'd like to know more about your interests. Please take a moment to check them off.
Backpacking?

Primary doingSecondary doingPrimary - Would like more InfoSecondary - Would like more Info
Carting?

Primary doingSecondary doingPrimary - More Info?Secondary - More Info?
Herding?

Primary doingSecondary doingPrimary - More Info?Secondary - More Info?
Obedience?

Primary doingSecondary doingPrimary - More Info?Secondary - More Info?
Agility?

Primary doingSecondary doingPrimary - More Info?Secondary - More Info?
Showing?

Primary doingSecondary doingPrimary - More Info?Secondary - More Info?
Therapy Dogs?

Primary doingSecondary doingPrimary - More Info?Secondary - More Info?
Tracking?

Primary doingSecondary doingPrimary - More Info?Secondary - More Info?
Breeding?

Primary doingSecondary doingPrimary - More Info?Secondary - More Info?
Rescue?

Primary doingSecondary doingPrimary - More Info?Secondary - More Info?
Want to be more active in the club? These are our Current Committees. Please indicate an area of potential interest. No experience necessary!
No committee interests at this time

PrimarySecondary
Awards: Organize awards program for members and their dogs.

PrimarySecondary
Breed Education / Breeder Referral: Provide materials to help educate all people about Bernese Mountain Dogs. Organize events to get this information out to club members and the public. Maintain official Club Breeder Referral List. Be the contact point for people looking to get a Bernese Mountain Dog. Help educate them about the breed and get them in contact with breeders.

PrimarySecondary
Draft: Organize drafting workshops and clinics. Provide instruction and encourage members to try drafting with their dogs. Keep abreast of Draft Test rule changes by the BMDCA and help organize our fall Draft Test.

PrimarySecondary
Fun Match: Plans the biggest club event of the year! Plan, organize and run the Fun match event. Includes set up, stewarding, judging and recording results.

PrimarySecondary
Health: Promote the health and welfare of BMDs by providing relevant health information and education, encouraging participation in research on BMDs and organizing events to promote health related activities, such as clinics, seminars, etc.

PrimarySecondary
Historian: Documents the history of the club through collecting newsletters, flyers, meeting minutes and photos. Maintains a club scrapbook with that information in it.

PrimarySecondary
Information Technology: Maintains club web site. Develops club databases. Provides guidance on technology issues for the club.

PrimarySecondary
Junior Membership: Develops program of activities for Jr. Members. Helps expand the program by attracting more juniors to become members. Publishes newsletter for Jr. Members.

PrimarySecondary
Membership: Contact for prospective members. Provides club information and coordinates the application process. Maintains membership information in the club database. Publishes the membership directory.

PrimarySecondary
Newsletter: Collects information, photos and articles from club members for inclusion into the Club Newsletter. Develops prints and mails the newsletter to all club members on a quarterly basis.

PrimarySecondary
Performance: Promote working dog performance activities, including Rally obedience, agility, tracking, skijoring, therapy, herding, and more. Plan and organize educational workshops and practice events

PrimarySecondary
Supported Entry: Works with the Board of Directors and the BMDCA to support the entry of Bernese Mountain Dogs at an AKC conformation show. Organizes sweepstakes if appropriate.

PrimarySecondary
Ways and Means: Raise funds SO the club can hold events for members. Responsible for raffles, and sales of merchandise at club events.

PrimarySecondary
Fund Raising: Plan and implement campaigns to solicit funds from other members and the community through personal solicitation, auctions, events, etc.

PrimarySecondary
Would you like to be notified of club activities by electronic mail in place of mailed flyers?

YesNo
I agree to abide by the rules of the American Kennel Club and the bylaws of the Heart of Michigan Bernese Mountain Dog Club, Inc.
Applicant Signature

Clear
Date

MonthDayYear
Date
Sponsorship: Our bylaws require that you be sponsored by two unrelated members of the Heart of Michigan Bernese Mountain Dog Club, Inc.
Sponsor #1 Signature

Clear
Sponsor # 1 Printed
Is Sponsor #1 your Breeder?

YesNo
Sponsor #2 Signature

Clear
Sponsor #2 Printed
Is Sponsor #2 your Breeder?

YesNo

Application Fees

Application Fee (one per application form)

$4.00 Quantity

Primary Adult Membership Fee (one adult)

$25.00 Quantity

Secondary Adult Membership

$12.50 Quantity

Total

$0.00

Credit Card

Should be Empty:

We'd like to know more about your interests. Please take a moment to check them off.

Want to be more active in the club? These are our Current Committees. Please indicate an area of potential interest. No experience necessary!

Credit Card