Gold Coast Australian Cattle Dog Club

Membership Application

Name: __________________________________________________ Phone: ______________ Cell Phone:_________________

Street: _______________________________ City: ______________ State: ____ Zip: ________

e-mail:______________________________________

Preferred contact method: ______e-mail _______US Mail ______Phone

Date of Application: ___________________ Occupation (AKC Request) ___________________

Registered Names and AKC Numbers

Dog's Name ______________________________________ AKC Number ______________

Dog's Name _______________________________________ AKC Number ______________

Area's of Interest - check all that apply

___Conformation ___Obedience ___Herding ___Tracking___Breeding ___Companion Dog ___Bylaws Committee

___Budget and Finance ___Standards Committee ___Matches Committee ___Search and Rescue

List of Other Dog Clubs and any Offices Held

______________________________________________________________________________

Breeding Activity (Please list sire, dam, and date of litter)

______________________________________________________________________________

Exhibiting Activity

Conformation________Obedience__________Agility__________Herding__________________

Gold Coast Australian Cattle Dog Club membership application

List the primary events you've attended in the last 12 months:

______________________________________________________________________

If you wish to include any other information please include another sheet.

Enclosed Fees

___$20 New Member ___$15 Renewal ___$20 Reinstate ___$25 Family ____$20 Family renewal

___$10 Associate ___$5 New Junior ___$5 Junior Renewal ____$10 Mailing fee- to receive newsletter by US Mail

Make checks payable to GCACDC and send to:

Debbie Crain, Treasurer

3317 Brittany Circle

Napa CA 94558

GCACDC does not restrict its membership to those who own AKC registered ACD's but because education

and preservation of the breed is our main goal we do require all members to sign the following agreement:

As a member of the Gold Coast Australian Cattle Dog Club, I agree to promote, preserve and protect the pure-bred Australian Cattle Dog

and abide by the constitution and bylaws of the Gold Coast Australian Cattle Dog Club and the rules of the American Kennel Club. I also

agree that I will not breed, nor will I breed to, a non AKC registered Australian Cattle Dog.

Signature of Applicant ______________________________

Signature of Signature of Parent or Guardian for Junior Member _______________________

Signature of Sponsor #1 __________________________

Signature of Sponsor #2 __________________________

For official use only ++++++++++++++++++++++++++++++++++++++++++++++++

Date Recieved by Treasurer ____________ Signature of Secretary___________________

Approved by Board __Yes __No ___________Date


				*Gold Coast Australian Cattle Dog Club* *Membership Application*



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		Gold Coast Australian Cattle Dog Club Membership Application Name: __________________________________________________ Phone: ______________ Cell Phone:_________________ Street: _______________________________ City: ______________ State: ____ Zip: ________ e-mail:______________________________________ Preferred contact method: ______e-mail _______US Mail ______Phone Date of Application: ___________________ Occupation (AKC Request) ___________________ Registered Names and AKC Numbers Dog's Name ______________________________________ AKC Number ______________ Dog's Name ______________________________________ AKC Number ______________ Dog's Name _______________________________________ AKC Number ______________ Dog's Name _______________________________________ AKC Number ______________ Area's of Interest - check all that apply ___Conformation ___Obedience ___Herding ___Tracking___Breeding ___Companion Dog ___Bylaws Committee ___Budget and Finance ___Standards Committee ___Matches Committee ___Search and Rescue List of Other Dog Clubs and any Offices Held ______________________________________________________________________________ ______________________________________________________________________________ Breeding Activity (Please list sire, dam, and date of litter) ______________________________________________________________________________ ______________________________________________________________________________ Exhibiting Activity Conformation________Obedience__________Agility__________Herding__________________ Gold Coast Australian Cattle Dog Club membership application List the primary events you've attended in the last 12 months: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ If you wish to include any other information please include another sheet. Enclosed Fees ___$20 New Member ___$15 Renewal ___$20 Reinstate ___$25 Family ____$20 Family renewal ___$10 Associate ___$5 New Junior ___$5 Junior Renewal ____$10 Mailing fee- to receive newsletter by US Mail Make checks payable to GCACDC and send to: Debbie Crain, Treasurer 3317 Brittany Circle Napa CA 94558 GCACDC does not restrict its membership to those who own AKC registered ACD's but because education and preservation of the breed is our main goal we do require all members to sign the following agreement: As a member of the Gold Coast Australian Cattle Dog Club, I agree to promote, preserve and protect the pure-bred Australian Cattle Dog and abide by the constitution and bylaws of the Gold Coast Australian Cattle Dog Club and the rules of the American Kennel Club. I also agree that I will not breed, nor will I breed to, a non AKC registered Australian Cattle Dog. Signature of Applicant ______________________________ Signature of Signature of Parent or Guardian for Junior Member _______________________ Signature of Sponsor #1 __________________________ Signature of Sponsor #2 __________________________ For official use only ++++++++++++++++++++++++++++++++++++++++++++++++ Date Recieved by Treasurer ____________ Signature of Secretary___________________ Approved by Board __Yes __No ___________Date