HMBMDC New Membership Application (3/25)

New Membership Application
HEART OF MICHIGAN BERNESE MOUNTAIN DOG CLUB, INC.
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.

Application Methods:

Complete form & mail to Jan Tiderington, 2444 Canterwood, Highland, MI 48357 Complete form, scan & email to Jan Tiderington at mjtider@comcast.net

Complete form online at HMBMDC.org

Payment Methods:

Check Payable to HMBMDC, Inc mailed to Jan Tiderington, 2444 Canterwood, Highland, MI 48357

Venmo to HMBMDC

Online at HMBMDC.org

Application Fee (one per application form) - $4.00

Primary Adult Membership Fee (one adult) - $25.00

Secondary Adult Membership (same household) - $12.50
Primary Member Name
Secondary Member Name
Address

Street Address

Street Address Line 2

City State ZipState / Province

Postal / Zip Code
Phone Number
Email Address
example@example.com
Secondary Email Address
example@example.com
Personal Website Kennel Name
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
Please provide information about your dogs
Dog #1 Call Name
Dog #1 Age
Dog #1 Registered Name & Titles (optional)
Dog #2 Call Name
Dog #2 Age
Dog #2 Registered Name & Titles (optional)
Dog #3 Call Name
Dog #3 Age
Dog #3 Registered Name & Titles (optional)
Are you a member of the Bernese Mountain Dog Club of America (BMDCA)?
Are you a Member of the Bernese Mountain Dog Club of America (BMDCA)?

Primary YESPrimary NOSecondary YESSecondary NO
Are you a Breeder of Bernese Mountain Dogs?:

YesNo
What is your Kennel Name
Date of last litter whelped

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

YesNo
List any HMBMDC events you have attended in the past year
Why do you want to join our club
What are you interested in doing with your dog? (Check ALL that apply)

Carting/DraftingHerdingBackpackingRallyNoseworkObedienceAgilityShowingBarn HuntTrackingBreedingTherapyRescueOther
Want to be active in the club? Please indicate an area of potential interest. NO experience necessary.

COMMITTEES
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 people about Bernese Mountain Dogs. Maintain official Club Breeder Referral List. Be the contact point from the club for people looking to get a Bernese Mountain Dog.

PrimarySecondary
Draft: Organize drafting workshops and clinics. Provide instruction and encourage members to try drafting with their dogs. Assist at Fall Draft Tests.

PrimarySecondary
Fun Match & Summer Picnic: Plan, organize and run the Fun Match & Summer Picnic 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: Maintain the history of the club through collecting & storing paper & online documents.

PrimarySecondary
Information Technology: Maintain club web site. Develop club databases. Provide guidance on technology issues for the club.

PrimarySecondary
Junior Membership: Develop program of activities for Jr. Members. Help expand the program by attracting more juniors to become members.

PrimarySecondary
Membership: Contact for prospective members. Provide club information and coordinate the application process. Maintain membership information in the club database.

PrimarySecondary
Newsletter: Collect information, photos and articles from club members for inclusion into the Club Newsletter. Develop, print and mail the newsletter to all club members on a quarterly basis.

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

PrimarySecondary
Supported Entry: Work with the Board of Directors and the BMDCA to support the entry of Bernese Mountain Dogs at an AKC conformation show.

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
Therapy Dog: Provides information about therapy dog training & opportunities.

PrimarySecondary
Holiday Party: Plan & help at the annual Holiday Party.

PrimarySecondary
Berner Blizzard Bash: Plan & help at the annual BBB in Rockford, MI.

PrimarySecondary
Fantasy of Lights Parade: Attend information meeting(s) about the Fantasy of Lights Parade in Howell, MI. Advertise & coordinate our entry in the parade.

PrimarySecondary
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
Sponsor 1 Signature

Clear
Sponsor 1 Printed
Is this Sponsor your Breeder?

YesNo
Sponsor 2 Signature

Clear
Sponsor 2 Printed
Is this Sponsor your Breeder?

YesNo
Payment Methods:

Check Payable to HMBMDC, Inc mailed to Jan Tiderington, 2444 Canterwood, Highland, MI 48357

Venmo to HMBMDC

Online Here - via Square

Application Fee (one per application form) - $4.00

Primary Adult Membership Fee (one adult) - $25.00

Secondary Adult Membership (same household) - $12.50

Credit Card via SQUARE

Application Fee

$4.00

Primary Members Fee

$25.00 Quantity

Secondary Members Fee

$12.50 Quantity

Total

$0.00

Credit Card

Should be Empty: