Application For Membership
Name
*
First Name
Last Name
Occupation and Employer:
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Breed(s) in which you own and/or are interest in:
*
Do you currently breed dogs, or plan to? If so, please explain:
*
Do you buy dogs for resale?
*
No
Yes
If yes, please explain:
Are you interested in any of the following?
*
Conformation
Performance Sports
Obedience
None of the above
Other
Do you plan to be an active member and regularly attend meetings?
*
Yes
No
Why do you wish to become a member?
*
Volunteer opportunities in which you are willing to assist with:
*
Spring Show
Fast CAT
Charitable Donations
Membership Committee
Awards Committee
Training Classes
None of the above
Other
I, the undersigned, understand that the North Country Kennel Club, Inc. reserves the right to accept or reject this application without recourse or reason.
Signature of Applicant(s)
*
Recommended by 1:
Recommended by 2:
Annual dues to accompany application. Single membership $20, family membership $30.
Membership Application received on:
-
Month
-
Day
Year
Date
Date
Elected or rejected on:
Date
Date
Meeting Attendance dates:
Submit
Submit
Should be Empty: