APPLICATION FOR MEMBERSHIP
Please fill out this page, print it out, and send it with the fee to:
GSDC of
Eastern Virginia
PO Box 15299
Chesapeake, VA., 23328
$25.00 for Individual Membership $30.00 for Family Membership
(Note: You must be able to attend meetings in the Tidewater Virginia Area)
NAME:
ADDRESS:
CITY/STATE/ZIP:
PHONE HOME: WORK: CELL:
FAX #: E-MAIL:
HOW MANY GSD'S DO YOU OWN? DOGS:BITCHES:PUPS:BROOD MATRONS:
AKC REGISTERED? YES NO ARE YOU IN GOOD STANDING WITH AKC? YES NO
INTERESTED IN SHOWING? YES NO IN BREEDING? YES NO
INTERESTED IN PERFORMANCE EVENTS? YES NO
HOW WOULD YOU LIKE TO SUPPORT THE GSDC OF EASTERN VIRGINIA
| Serve on committee/help at event? | Purchase club decals, pins? |
| Breed/Rescue/Training Classes? | Contribute to Newsletter/Education Programs? |
| Support the club w/trophy donations? | Therapy Dog Activities/Search & Rescue? |
Do you have a special talent that would be of benefit to this club?
I, THE UNDERSIGNED, hereby apply for membership in the GSDC of E. Va., and certify that I am at least 18 years of age. I agree to abide by the Constitution and By-Laws of the GSDC of E. Va. and by the rules and regulations of the American Kennel Club. I hereby certify that I am in good standing with the American Kennel Club. Should my application be denied, the Club is not obligated to make reason(s) known.
Signature:_________________________________________________Date:____________
Signature:_________________________________________________Date:____________
For Club use only (do not write in this space)
Check #:_________ Cash Money Order
Accepted Date:_______________ Pending Date:_______________ Denied Date:_______________
Notes:_______________________________________________________________________________________________________________