LENAPE BULLDOG CLUB OF PENNSYLVANIA

MEMBERSHIP APPLICATION

 

NAME:___________________________________________________

 

ADDRESS:________________________________________________

               

                ___________________________________________________County__________________

 

TELEPHONE:(       )_____________________________  Email :_____________________________

 

PLEASE CIRCLE ALL THAT APPLY BELOW:

B- registered a litter with the AKC in the past three years

DO- interested dog owner.  Have one or more registered AKC dogs but not active in the sport

V- licensed Veterinary

VT- licensed vet. tech.

J- an AKC licensed judge

E- exhibitor- one who has entered an AKC licensed event in the past two years

 

PLEASE ANSWER THE BELOW QUESTIONS:

Have you placed an AKC Title on your dog(s) ?    YES        NO     If “Yes” please list the title and date:

 

SIGNATURE:___________________________________  DATE:____________________

 

PROPOSED BY:    __________________________________________

 

                                ____________________________________________

TYPE OF MEMBERSHIP(CHECK ONE)

(    ) FULL VOTING $10.00/YEAR (must attend 2 meetings before being voted on)

(   )  ASSOCIATE MEMBER- NON-VOTING $10.00/YEAR

 

MAIL COMPLETED APPLICATION TO:

                                                                         Lisa Treffinger

                                                                        1104 Church Rd

                                                                East Greenville, PA 18041

 

 

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DO NOT WRITE BELOW THE LINE

FOR CLUB USE ONLY

 

 

DATE SUBMITTED: ______________________ (1ST READING)

 

DATE OF TWO ATTENDED MEETINGS(full membership):_____________ &__________________

 

APPROVED BY MEMBERSHIP:_________________________