Membership Application

Name:_________________________________________________________

Spouse (Family Membership):_____________________________________

Address:_______________________________________________________

City/State/Zip:__________________________________________________

Telephone(day/evening):_________________________________________

Fax:___________________________________________________________

Email:_________________________________________________________

How did you hear about our club:__________________________________

Please tell us a little bit about your interest in dogs:

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How many dogs do you own? What breed(s) are they?

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Do you breed or show your dogs?
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If so, how many litters do you breed in a year?
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Have you ever sold to a pet store, distributor, or had other people sell dogs for you?

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Do you belong to any other dog clubs or participate in any other dog-related activities?

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Membership Type:
( )Regular-member must attend meetings and has voting privileges. Must work for the club for 6 months before being voted into the membership. Receives meeting notices and newsletters.
( )Family-members same as a regular membership. All family members who wish to join the club are required to perform the duties of regular membership.

Sponsor: If applying for Regular Membership, you will need to supply  a reference (you can use your vet if you do not know any club members, please include the vet's telephone number):

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Amount Paid:
$ TBD - Regular Membership

 

Your Interests
(circle all that apply)

Breeder	Exhibitor	Handler	Rescue
Obedience	Agility	Pet Owner	Other:____________

You (as well as family club members) are required to serve on a DVPC committee or position.
Circle which one(s) you are interested in:

Vice-President	Secretary	Treasurer	Board Member
APC Liaison	Membership	Programs	Historian/Sanctioning
Fund Raising	Publicity	Obedience	Constitution/Bi-Laws
Match Show	Sunshine	Rescue	Other:____________

Please explain your qualifications for the offices or committees which interest you:

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Do you have any ideas for a Program? Can you provide a program for the DVPC? Please describe:

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