Printable Membership Application for the Berrien Kennel Club.
Comments
Content
First Reading ________________
Second Reading _____________
Third Reading _______________
Berrien Kennel Club
Application for Membership
Please Print
Name _________________________________________________________________________________________
(Last) (First)
Address ______________________________________________________________________________________
City ___________________________________ State _________________________ Zip Code ____________
Phone Number ______________________________________________________________________________
Email _________________________________________________________________________________________
Occupation ___________________________________________________________________________________
List the breed(s) you have owned __________________________________________________________
_________________________________________________________________________________________________
How many litters have you registered with the American Kennel Club? _________
How many dogs you do currently own or co‐own? ___________________________________
About how many shows and/or performance trials do you attend per year?
Number of shows _______ None, I am in the process of learning _______
Please describe your kennel facilities ______________________________________________________
_________________________________________________________________________________________________
Have you ever been a member of a dog club? Yes ______ No ______
Are you currently active? Yes ______ No ______
If yes, please list the clubs and indicate if you have been an officer in that club
_________________________________________________________________________________________________
Have you ever been suspended from the privileges of the American Kennel Club?
Yes ______ No ______
What category best describes your involvement in dogs? Check each that applies.
Exhibitor _____ Breeder _____ Pet Owner _____ Kennel Operator _____ Hobby _____
Grooming _____ Pet Shop _____ Professional Handler _____ Judge _____ Other _____
REFERENCES: Please list 3 references with their addresses & phone numbers.
Preferably 2 references are exhibitors and/or connected with purebred dogs in
some manner.
1) ____________________________________________________________________________________________
I hereby agree that if membership to the Berrien Kennel Club is granted to me,
1. I shall abide by and be governed by the rules and regulations of the
American Kennel Club.
2. I shall be an active participant in the Berrien Kennel Club activities and
projects.
3. I shall abide by the terms and conditions set forth in the Constitution and
By‐Laws of the Berrien Kennel Club.
4. I understand that there may be an in‐home interview with a kennel
inspector of my facilities by the membership committee prior to my third
meeting.
I have read the above terms and understand them fully. Being in agreement and
with my signature, I do hereby apply for membership in the Berrien Kennel Club.
Signature _________________________________________________________ Date ________________________
DO NOT WRITE BELOW THIS LINE
……………………………………………………………………………………………………………………………………………………….
Date Received: _____________________________
Date Accepted: _____________________________
Date Rejected: _______________________
Member is a: Single membership ______
Junior membership ______
FEE PAID: $ _________________
_________________________________________________________________________________________________
Membership Committee Person Signature