Name(s):_________________________________________.
Address:_________________________________________.
City:_________________________________________.
State/ZIP:_________________________________________.
Phone:_________________________________________.
E Mail:_________________________________________.
Breeds Owned:_________________________________________.
Titles Held:_________________________________________.
Are you interested in obediance:_________.
Are you willing to be of service to the club?:_________________________________________.
Are you interested in holding office:_________________________________________.
Would you like to become a breed or multi breed judge for the U.K.C.?:_________________________________________.
List children wishing to join JR membership:_________________________________________.
Membership Dues: $10 Personal $20 Family
Signature and Date:_________________________________________.
Send completed application and check or money order payable to:
Note: Dues are to be paid once a year on January 1st with a grace period of 30 days.
