City:_______________________ State:_____ Zip:__________
Phone: (_____) _____________ Email: ___________________________________
What breeds do you own?_________________________________________________________________
How many dogs do you own?_____ How many litters have you bred?_____
Do you show in:
conformation?_____ obedience? _____ agility? _____ field? _____ herding? _____ other? _____
Are you an active member of any dog club(s)? _____
If so, please indicate club(s):_______________________________________________________________
Have you belonged to any club(s) in the past? ___ If so, please list: (if you need more room use back or other sheet)
Name of Club Dates of Membership Office(s) Held/Activities
Do you have a kennel name? ____ If so, indicate name: _____________________________________________________________________________________
Is your kennel name AKC registered? _____
Do you sell puppies to wholesalers, by litter lots, or for resale? _____
Do you sell puppies to individual buyers? _____
Please describe any activities or special interests, past experience, or any area in which you would be willing to work, that you feel might help you to make contributions to the efforts of the Warrenton Kennel Club.
If accepted for membership, I agree to abide by the Constitution and By-Laws of the Warrenton Kennel Club which create and promote sportsmanship and interest in purebred dogs. I agree to contribute my knowledge and experience when asked and to respect the purpose and support the activities of this club.
______________________________________________________ Signature of Applicant
Sponsors: (1) ______________________________________
Membership Application Submitted at Meeting on : ________/_______/__________
First Reading: ______/______/_______ Second Reading:_____/_______/_____
Membership Fees: Single $10.00. Two persons Same Household $15.00. Junior membership $5.00. Dues must accompany membership application. In the event the membership is not approved or is withdrawn, dues will be refunded.
Please note: The membership application may be submitted after attending one meeting as a guest. It will be read at the next meeting the applicant attends and read a second time and voted on at the third meeting. If the application is for two persons in same household, both must attend.
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