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AMERICAN COCKER SPANIEL
CLUB OF VICTORIA INC
2006

MEMBERSHIP FORM

NAME…………………………………………………………………….

ADDRESS……………………………………………………………….

…………………………………………………………………………….

PHONE NO……………………………… POST CODE……………

KENNEL NAME…………………………………

REGISTERED NO............

Email address .....................

Membership Fees

________________
Dual $25.00 ………

Single $22.00 ………

Joining Fee 5.00 ……….

New Zealand & Overseas add A$10.00

Australian Dollars

Total Paid ………………

Application and fees to be forwarded to

The Secretary,
M's.Elaine Murphy
39 Menzies Road
Menzies Creek 3159

Membership Fees are due and payable on the 31st October Each Year.

Any membership renewal paid after 31-12-2005

Must pay a rejoining fee.

All new memberships must pay joining fee:

Non Members of VCA must pay:: Levy to Cover Insurances:

Single $6.50 Duel $13.00

All Intersate and Overseas members exempt:

BREEDER’S LISTING

__________________
(Yankee Doodle Dandy) – Unaltered copy (business size card) to appear in all issues of Y.D.D. for a period of 12 months. A$10.00

Copy or information required in listing to be forwarded with fees to
Club Secretary.

RECEIPT NO. (Club use only) …………… Date Received …………….

1