Membership Renewal & Dues Form

Clumber Spaniel Club of America Membership Renewal & Dues Form

Confirm your membership details and submit your renewal dues.
Is this a single membership or household membership?
Member 1 Name

First NameLast Name
Member 2 Name

First NameLast Name
Member/Household Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Number in household
Member 1 Email Address
example@example.com
Member 2 Email Address
example@example.com
Member 1 Primary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Member 2 Primary Phone
Please enter a valid phone number.Format: (000) 000-0000.
Member 1 Secondary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Member 2 Secondary Phone
Please enter a valid phone number.Format: (000) 000-0000.
Dues paid on line or postmarked after March 1, 2027 require a late fee of $ 10.00
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Single Membership Renewal (U.S. membership)
Renew your single membership for another year.

$50.00



Single Membership Renewal (Outside U.S.)
Renew your single membership for another year.

$65.00



Household Membership Renewal (U.S.)
Renew your family membership for another year.

$60.00



Household Membership Renewal (Outside of U.S.)
Renew your family membership for another year.

$75.00



Junior Membership (up to 17 yrs old)
Renew your junior membership for another year.

$15.00



Associate Membership
Renew your associate membership for another year.

$10.00



Total

$0.00
Kennel Name
Website
Renewal Confirmation
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Are you renewing for a junior membership?
Junior

First NameLast Name
Do you give CSCA permission to include your junior(s) contact information in the directory?
Parent/Guardian Consent for CSCA Directory - I give permission for CSCA to include my junior's personal information in the CSCA directory.
Our club thrives because of amazing members who volunteer. Please check any areas you would be willing to jump in and help!

Other
The Clumber Spaniel Club of America (CSCA) respects your privacy. Any and all personal information collected by the club concerning its members will be kept strictly confidential. Your personal information will never be sold and will not be disclosed to unaffiliated third parties without your permission. Your information will be shared in the CSCA membership directory, the CSCA Bulletin, and via any other forms of communication within the CSCA that are allowed by its Constitution and Bylaws. Your personal information will be shared with the Clumber Spaniel Health Foundation (CSHF) and the Clumber Spaniel Rescue Charitable Trust (CSRCT) unless you specifically choose to opt out. If you do so choose, please indicate below by placing a check mark beside the applicable statement(s).
Please consider donating to CSCA or affiliated charities through this link:

Donation Link

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

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Clumber Spaniel Club of America Membership Renewal & Dues Form

Dues paid on line or postmarked after March 1, 2027 require a late fee of $ 10.00*

Payment Methods

Dues paid on line or postmarked after March 1, 2027 require a late fee of $ 10.00