 |
Membership Application |
I hereby make application for membership
in the Evergreen Shiba Inu club. I agree to abide by the Constitution
& By-Laws
and Code of Ethics of this club.
Name: ___________________________________________________________________________________________________
Address:_________________________________________________________________________________________________
City:_____________________________________________________________________________________________________
Phone___________________ Kennel Name (if any)________________________________________________________________
Breeds owned: ____________________________________________________________________________________________
Other Breed Clubs you belong to:_______________________________________________________________________________
________________________________________________________________________________________________________
Have you ever been suspended by AKC or been subjected to discipline by a Breed Club?
No____ Yes ____ If Yes, please explain: ________________________________________________________________________
_________________________________________________________________________________________________________
Applicant's signature (s) _____________________________________________________
Date: ______________________________________________________
Membership Sponsor_______________________________________________________
Club Officer Sponsor________________________________________________________
Annual Dues: Individual $15.00 Family: $20.00
Submit application and fee to: Lucy
Tracy, Corresponding Secretary
|
Evergreen Shiba Inu Club 13025 Sw Riggs Rd Powell Butte, OR 97753-1514 Phone: 541 504-1088 |
Make Checks Payable to: Evergreen Shiba Inu Club
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General Membership Vote: For _______ Against ______
Accepted: ______ Rejected ______
Date: __________________________
Reason for rejection: ___________________________________________________________________________
____________________________________________________________________________________________