West Texas Brittany Club

Membership Application

 
 
Name:   ___________________________   Phone:   __________________
 
Address:   ___________________________   E-Mail:  __________________
 
City:   ___________________________   State:  ___  Zip Code:  _______
 
Dog's Name:   ___________________________   Breed:  ___________________
 
Dog's Name:   ___________________________   Breed:  ___________________
 
Dog's Name:   ___________________________   Breed:  ___________________
 
Primary Interests:  [__]Hunting  [__]Field Trials  [__]Hunt Tests  [__]Dog Shows
  [__]Obedience  [__]Agility  [__]Pet  [__]Other ________________
 

Membership Type (check one)

[  ]   I am enclosing dues of $30.00 for a "Full" membership, which includes a subscription to "The American Brittany" magazine.
 
[  ]   I am enclosing dues of $3.00 for an "Associate" membership, which does NOT include a subscription to "The American Brittany" magazine.
 

Please print this page using your browser print button and mail to:
West Texas Brittany Club
c/o Jan Kilpatrick
7865 CR 271
Hico, TX  76457

West Texas Brittany Club
http://home.earthlink.net/~txbrits/wtbc/