MEMBERSHIP APPLICATION
WATERLOO KENNEL, CLUB INC.

Applicant’s Name: ____________________________________________________________________

Address: _________________________________________  Phone: ____________________________

City: ____________________________  State: ________________  Zip: _________________________

Occupation: __________________________________________________________________________

Kennel Name: ________________________________________________________________________

Do you have a kennel license?  (  )Federal,  (  )State,  (  )Hobby,  (  )Commercial,  (  )Boarding
Are your dogs a hobby? (  )Yes,  (  )No                   Commercial venture?  (  )Yes,  (  )No
Primary breed: _________________________________ 
Number of breedable bitches: __________________  Number of stud dogs: ____________________
Numbers of litters in the last 2 years? _______________
Other breeds: __________________________________
Number of breedable bitches: __________________  Number of stud dogs: ____________________
Numbers of litters in the last 2 years? _______________
DO YOU BUY OR SELL INDIVIDUAL DOGS OR LITTERS FOR RESALE? ___________________

List all dog clubs or organizations you have belonged to: ______________________________________

____________________________________________________________________________________

List all dog clubs or organizations you presently belong to: _____________________________________

_____________________________________________________________________________________
Areas of interest: (  )Conformation, (  )Obedience, (  )Field Trials, (  )Breeding
Do you plan to regularly attend meetings? (  )YES,  (  )No
Are you willing to help with the club’s dog show, matches, and training classes? (  )YES,  (  )No
Have you already helped at any club functions? (  )Yes,  (  )No   Explain: __________________________

Please use the back of this sheet for any further comments you would like top make.
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The  yearly membership fee in the Waterloo Kennel Club, Inc. is $10.00 per member.  Payment must be submitted with the application for membership.  Two Waterloo Kennel Club members must sponsor the applicant.  Any false or misleading statements on this application may be grounds for revocation of membership.

Please accept my application to the waterloo Kennel Club, Inc.  If I am accepted as a member, I agree to abide by the rules and regulations of the club and the American Kennel Club.  I will take an active part in club activities.

Signature of applicant

Signature of sponsor					Signature of sponsor