TIOGA COUNTY KENNEL CLUB, INC.

MEMBERSHIP APPLICATION

Name: _______________________________________________________________________

Family Members: ______________________________________________________________

Address:_______________________________________Phone:__________________________

City:__________________________________State:__________Zip Code:_________________

E-mail:________________________________________________________________________

Breeds of Dogs Owned:__________________________________________________________

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

Number of litters bred during the last two years:_________________

AKC Titles obtained during the last two years:__________________

Why do you want to join TCKC, Inc.?_______________________________________________

____________________________________________________________________________

____________________________________________________________________________

What interest, hobbies, skills do you have which you would be willing to share?______________

____________________________________________________________________________

Other dog organization you belong to:_______________________________________________

List special interests:____________________________________________________________

REQUIREMENTS FOR MEMBERSHIP APPLICATION:

1. All prospective members are asked to attend three (3) meeting before submission of application. This is so you can get to know us, and be sure you want to be a member of TCKC, Inc. and we can get to know you. Sponsors are required to attach character reference letter to application.

OR

2. Visitation committee to come to your home. Recommendation of visitation committee may be used in lieu of sponsors. Members of visitation are members in good standing with TCKC, Inc.

As a member of TCKC, Inc. you are asked to help with three (3) events/activities during the year.

PLEASE CHECK THREE (3) OPTIONS: __ point show __match __seminars

___ tattoo/microchip __ holiday party __ways and means ___any committee that needs me

I agree to abide by the constitution and by laws of the Tioga County Kennel Club, Inc. and the rules of the American Kennel Club, Inc.

Signed:_____________________________________________Date:____________________

Sponsors signature:1.________________________________2.________________________________

___1 year Trial single membership $15.00 ___ 1 year Trial family membership $20.00

Return application to Membership Chairperson:

Vicki Kubic

513 River Terrace

Endicott, NY 13760

----------------------------------- TCKC, Inc. Use Only -------------------------------------------------------------------------------

Check:____Cash:______ Date received:__________ Received by:_____________________

Sponsor letters attached? Sponsor 1__ Sponsor 2____

Visitation Committee________ Recommendation: _____________________________

Dates attended meeting prior to vote: _______ ________ ________

Application Read:_______

Date voted on:_________

Results of vote: ____ yes ____no ____Abstain