Note: Vicki Kubic must receive dues before January 31, 2008.
IF NOT RECEIVED BY THAT DATE, YOU MUST REAPPLY FOR MEMBERSHIP.

THIS FORM MUST ACCOMPANY PAYMENT!

Name:______________________________________________________________

Address:____________________________________________________________

City__________________________________ State_____________ Zip_________

Phone:______________________________________________________________

Email address:__________________________________________________________

Breed(s) of Dog(s):_______________________________________________________

Circle all that apply: Exhibitor Breeder Owner Judge Trainer Handler Fancier

TYPE OF MEMBERSHIP DESIRED

____ Single Associate - $15.00 ___Single Regular - $15.00

(Cannot vote or hold office)

____Family Associate - $20.00 ___Family Regular - $20.00

(Cannot vote or hold office)

PLEASE FORWARD CHECK OR MONEY ORDER PAYABLE TO:

TIOGA COUNTY KENNEL CLUB, INC.
Vicki Kubic
Membership Chairman (2008)
513 River Terrace     Endicott, NY  13760