MEMBERSHIP APPLICATION
General Members must live
in Montana, Idaho, North Dakota, South Dakota, and Eastern Washington.
Two sponsors
who are General Members in good standing must sign
application. New Membership Applications for General
Members should include additional, non-refundable, one time
processing fee of $5.00 which covers the cost of
mailing an education pack to all persons applying for
membership. Subscribers and other types of membership
may also choose to order this package for an additional $5.00
fee.
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TYPE OF MEMBERSHIP APPLIED FOR: (please check choice) |
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Individual
Membership |
Persons 18 and over and
in good standing with the AKC and NCA. They will be entitled to all
privileges and responsibilities of the club, including holding office
and voting. |
$25.00 |
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Family Membership |
Two adults residing at
the same address and all children of the family. Both adults have full
privileges and responsibilities of the club, including holding office
and voting. |
$30.00 |
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Junior Membership |
Persons under 18 in
good standing with the AKC and NCA. They will be entitled to all
privileges and responsibilities of the club, except holding office and
voting. |
$10.00 |
|
Affiliate Member |
Out of region
individual or family in good standing with the AKC and NCA.
(Non-voting, includes Newsletter |
$20.00 |
I (we) hereby apply for membership in the GLACIER NEWFOUNDLAND
CLUB. If approved for membership, I (we)
agree to abide by the By-Laws of the GLACIER NEWFOUNDLAND CLUB.
NAME(s):________________________________________________________________________________
ADDRESS:_______________________________________________________________________________
CITY:____________________________STATE_________ZIP__________
PHONE: Home_____________________
Work_____________________
FAX #_______________________
E-Mail address ______________________________________________
OCCUPATION:__________________________________________________________________________
What other
dog clubs do you belong to:
_______________________________________________________
_______________________________________________________________________________________
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Newfoundland Dog Ownership |
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Call Name |
Color |
DOB |
AKC # |
Breeder |
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*Color BK-Black, BR-Bronze, L-Landseer
Are you a member of the Newfoundland Club of America, Inc.?
_____
Yes
______ No
Are you a member of any other Newfoundland clubs?
_____ Yes ______ No
(Over to
page 2)
Membership application – page 2
Areas of Interest:
(please
check areas you wish to learn more about and to participate in:
____ Conformation ____ Obedience ____ Carting ____Draft work ____
Water work ____ Tracking
____ Grooming ____ Community Service ____ Breeding ____ Junior
handling ____ Agility
____ Other
_____________________________________________________________________
Volunteering Interests:
(Please check items you would be willing to help
out with and learning more about by
volunteering:
____ Newf Rescue ____ Water tests and clinics ____ Draft tests and
clinics ____ Stewarding ____ Fun Match
_____Fund Raising ____ Carting _____Annual Awards Dinner
____Officer/Director ____ Newsletter
_____Other
______________________________________________________________________
Applicant Signature and Date Applicant Signature and Date
____________________________ __________
(Name) (Date)
____________________________ __________
(Name) (Date)
Note to sponsors: By sponsoring this/these applicants, you take on
the responsibility of calling them and
inviting them to participate in club functions during the initial
application process period.
____________________________ __________
(Sponsor’s
Signature) (Date)
____________________________ __________
(Sponsor’s
Signature) (Date)
Please send completed application with applicable fee, to:
Tony DeVoe
184 W. Bowman Dr
Kalispell, MT
59901
Phone: (406) 756-7434
E-Mail:
tdevoe@j34whitestar.com
Date Recvd._______________
Check #: ______________
Amount__________________
Date Accepted: ___________
(application revised 3/20/2007)
