Membership Application
This application is for one person.
Name
*
First Name
Last Name
Occupation
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone
Please enter a valid phone number.
Format: (000) 000-0000.
FAX
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
How long have you lived in the Portland metropolitan area?
If new to the Portland area, where did you move from?
Which AKC breeds are you nvolved with?
*
Put each breed on a new line.
What is your current status with AKC?
Good
Other
If other, please explain:
How many years have you been involved in AKC activities?
What activities are you (or have you been) involved in with your purebred dog(s).
Conformation
Obedience
Rally Obedience
Agility
Other
If you do any breeding with your dog(s), how many litters per year (average)?
When was the most recent AKC inspection of your breeding facility?
Have you done any ring stewarding?
*
Yes
No
If not, would you be willing to learn ring stewarding?
*
Yes
No
Are/have you been a member in good standing of other AKC clubs?
*
Yes
No
If so, please specify:
Why are you interested in becoming a member of the Dog Fanciers' Association of Oregon?
*
If you were to become a member of DFAO in what ways can you best contribute to the Club's continuing success?
I would be willing and able to (choose your preference):
attend monthly meetings
work on committees
mentor novice fanciers
ring steward for local shows
Sign & Pay Dues
I have completed this application truthfully, to the best of my knowledge. I understand that all information given may be reviewed for verification by the DFAO Membership Committee i order to make its final recommendation to the Dog Fanciers' Association of Oregon membership and board.Applicant Signature
List the name of the DFAO member who is sponsoring your membership.
*
prev
next
( X )
Regular Membership
$15.00 dues + $1 PayPal fee
$16.00
$
16.00
loading smart payment buttons...
The payment is ready! It will be completed once you submit the form.
Submit
Should be Empty: