HEARTLAND CHAPTER
White German Shepherd Dog Club International, Inc.

MEMBERSHIP APPLICATION

NAME: (please print)
ADDRESS:
CITY: STATE: ZIP:

Please list the breed(s) (including W.G.S.D.) you own, their registered names, and AKC numbers. (Use back of application if necessary).

What dog activities are you interested in?
Therapy Dogs Dog Rescue Obedience
Conformation Breeding Other

Are you planning to attend club activities? Yes No

Are you available to help with club activities? Yes No

Do you have any special skills that you would be willing to share with the club? Yes No

Why do you want to join this Chapter of the WGSDCI? (Please be specific)

What other clubs or groups (related to dogs) do you belong to?

I, _______________________________, hereby request acceptance as a member of the Heartland Chapter of the White German Shepherd Dog Club International. My sponsors are: _______________________________ and ____________________________. I understand that my application must be approved by the Club's Board and that I will be notified in writing within thirty (30) days of the Board's decision. I am including my first year's dues, which will be refunded if my application is not accepted.

Code of Conduct

As a responsible member, I will accept and follow the rules and regulations as determined by the national and local organization. I will not intentionally wrong a fellow member or their dog(s), not will I allow others to do so in my presence. I will conduct myself in a sportsmanlike manner. I will maintain the highest quality standards of health and care for my dog(s). I will take responsibility for any dog(s) I may sell. I understand that by violating any or all of this pledge, I open myself up to disciplinary action by the governing Board.

Applicant's Signature: ____________________________________________ Date: _______________
Sponsor's Signature:______________________________________________ Date: _______________
Sponsor's Signature:______________________________________________ Date: _______________

PLEASE FILL OUT, PRINT, SIGN AND MAIL APPLICATION (with dues) TO:
Joyce Ann Matejcek
1733 West Eldridge Avenue
Roseville, MN 55113

Annual Dues: $5.00 (single); $7.50 (family); $2.50 (junior)
New Members please add $5.00 application fee

(Click HERE to RETURN to Chapter Page).

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