Flagship Dog Sports Club Membership Form

Flagship Dog Sports Club Membership Form
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Dog 1 Name
Dog 1 Breed
Dog 2 Name
Dog 2 Breed
Dog 3 Name
Dog 3 Breed
Dog 4 Name
Dog 4 Breed
Have you bred any liters in the past 3 years?
Do you have any AKC event committee experience?
Are you an AKC Judge?
Have you exhibited in any AKC trials in the past 2 years?
Years of Scent Work Experience (must be within the last 2 years)
Years of Conformation Experience (must be within the last 2 years)
Years of Agility Experience (must be within the last 2 years)
Years of Obedience Experience (must be within the last 2 years)
Years of Rally Experience (must be within the last 2 years)
Years of Lure Coursing Experience (must be within the last 2 years)
Years of Herding Experience (must be within the last 2 years)
Years of Field Trials Experience (must be within the last 2 years)
Years of Earth Dog Experience (must be within the last 2 years)
Years of Frisbee Experience
Name of 1st Club Member Sponsoring your membership
Name of 2nd Club Member Sponsoring your membership
I agree to abide by the Bylaws and Standard Operating Procedures of Flagship Dog Sports and the rules of The American Kennel Club.
CLUB PAYMENTS
You can mail a check or pay using the Zeffy QR code below.
Please mail your membership check to:

Elicia Pace, Treasurer

FDS/NWPASWA

10250 Tiger Lily Lane

Waterford PA 16441

Make checks out to NWPASWA
Should be Empty:

Flagship Dog Sports Club Membership Form

CLUB PAYMENTS