Flagship Dog Sports Club Membership Form
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / 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
Have you bred any liters in the past 3 years?
Please Select
Yes
No
Do you have any AKC event committee experience?
Please Select
Yes
No
Are you an AKC Judge?
Please Select
Yes
No
Have you exhibited in any AKC trials in the past 2 years?
Please Select
Yes
No
Years of Scent Work Experience (must be within the last 2 years)
Please Select
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Years of Conformation Experience (must be within the last 2 years)
Please Select
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Years of Obedience Experience (must be within the last 2 years)
Please Select
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Years of Rally Experience (must be within the last 2 years)
Please Select
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20+
Years of Lure Coursing Experience (must be within the last 2 years)
Please Select
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20+
Years of Herding Experience (must be within the last 2 years)
Please Select
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20+
Years of Field Trials Experience (must be within the last 2 years)
Please Select
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20+
Years of Earth Dog Experience (must be within the last 2 years)
Please Select
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20+
Years of Frisbee Experience
Please Select
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Name of 1st Club Member Sponsoring your membership
Name of 2nd Club Member Sponsoring your membership
CLUB PAYMENT - $30/year (after Nov 1st it includes next year)
Submit
Should be Empty: