IWC New Membership Application

International Windsprite Club (IWC) Membership Application
Please fill out form completely, and double check before clicking the "SUBMIT" button at the very end.

All fields with an * are required.
APPLICANT INFORMATION
Date

MonthDayYear
mm-dd-yyyy or use calendar button
Name*

First NameLast Name
Address *

Street Address

Street Address Line 2

CityState/Province

Zip/Postal CodeCountry
Home Phone Number

Area CodePhone Number
Mobile Phone Number

Area CodePhone Number
Email*
example@example.com
Membership Type*

IndividualFamilyJunior (age 10-17)
Age if Junior
Additional Names for Family Membership:
Name, Age, Email
Name, Age, Email
Name, Age, Email
An endorsement by a current IWC member in good standing is required for your membership application to be considered. A link to the form for the endorser to fill out can be found on our website membership page.
Endorser's Name
Endorser's Email
Agreement:

With my signature I certify that the above information is true and complete, and I agree to comply with the Code of Ethics, to support the Bylaws, and to strive to fulfill the Mission and Vision of the International Windsprite Club.
E-Signature (Parent/Guardian if < 18 years of age)
Typed signature constitutes a valid electronic signature
APPLICANT PROFILE:
Occupation:
Do you currently own a Windsprite or have you in the past? (Membership is not dependent upon owning a Windsprite)*

I currently own a WindspriteI have prevoiusly owned a WindspriteI have not owned a Windsprite
Number of Years in Windsprites?
Number of Windsprites currently owned?
Have you ever bred a litter of Windsprites?
Other breeds you have owned or bred?
Areas of Interest (check all that apply)

ConformationBreedingAgilityLure Coursing/RacingObedience/RallyDock DivingNosework/Barn HuntFlyballOther
Do you have active membership in any other dog clubs? If yes, please list the name of the club(s) and offices held, if any.
Are you an approved judge for any canine activity? If so, list which activity and organization. (ie agility/CPE)
Please list any areas of Club related activity in which you might like to become involved.
Additional questions or comments?
Dues (check one):

Individual Membership - 1 year $20Individual Membership if Applying after July 1 $10Family Membership - 1 year $30Family Membership if applying after July 1 $15Junior Membership 1 year $10Junior Membership if applying after July 1 $5
Payment Due: $
Payment:*

Payment via PayPal: Send to treasurer4iwc@gmail.comPayment by Venmo: Send to @International-Windsprite ClubPayment by Check or Money Order made out to "IWC": Send to IWC c/o SIdney Hoblit 33 Pine Grove Rd, Nottingham PA 19362
If you have any questions or problems with filling out the form, contact Sidney Hoblit LHWLady@gmail.com
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International Windsprite Club (IWC) Membership Application