Return to: Marilyn Impomeni, Corr. Sect. 66 Parkway Rochelle Park, NJ 07662 (201) 368-0994

Yearly Dues: Family $25.00 Single $15.00 Payable with Application

I(We), hereby apply for membership in the Garden State Weimaraner Club. I (We) promise to abide by the Constitution and By-Laws of the Club and the rules of the American Kennel Club and Weimaraner Club of American when applicable. I (We) further agree to abide by the terms of the Breeders Code of Ethics as listed on the reverse side of this application.

NAME:____________________________________________________________________________________

ADDRESS:_____________________________________________ PHONE # ____________________________

OCCUPATION:________________________________________ BUS PHONE # _________________________

Number of Weimaraners Currently owned: _________________________

List name(s) of dog(s) and AKC Registration Number(s):

__________________________________________________________________________________________

__________________________________________________________________________________________

I (We) are interested in:participating and helping with the following activities:

FIELD___________BENCH___________OBEDIENCE___________TRACKING__________RESCUE__________

List memberships (if any) in other Clubs:

_______________________________________________ __________________________________________

_______________________________________________ __________________________________________

ENDORSED BY:

_____________________________________________ and _________________________________________
 

________________________________________________________________

Signature of Applicant(s)

You must attend one meeting OR work at an event prior to the Club acting upon your application.

Date of Approval_____________________________