MEMBERSHIP APPLICATION

After reading the GSVKC Constitution and By-Laws and reviewing the GSVKC Code of Ethics, complete the applicant section of the application and bring it to a general membership meeting along with your first year’s dues. Provide the application and dues to the Secretary prior to the start of the meeting. For copies of club documents, meeting times and locations, visit www.gsvkc.org.

Instructions: Click on checkboxes to insert an “X”. Use Tab key to move to each shaded area and type in requested information.

To be completed by Applicant:

Membership Type: Individual Junior

Name:

Address:

City State Zip

Email: Home Phone #: ( )

Work Phone #: ( ) Cell Phone #: ( )

Occupation/Place of Employment:

Breeds you currently own:

1. Do you compete with your dog(s) in Conformation Obedience Rally Agility Junior Showmanship Herding Other, please specify:

2. Are you currently a member of or have you belonged to any dog related clubs in the past? Yes No If ‘Yes’, please list name and club contact information:

If ‘Yes’, are you and were you always a member in good standing?

Yes No

3. Have you ever been expelled from OR denied membership in a dog/kennel club?
Yes No If ‘Yes”, club:

4. Have you ever been fined/suspended by the American Kennel Club?
Yes No If ‘Yes’, please explain:

5. Please list any dog show or dog related experiences (obedience trainer, show chairman, etc) you bring to our club:

6. List any other information that would be helpful in our accepting you as a member:

I am in good standing with the American Kennel Club and am not presently under suspension from any dog or kennel club. I have read and agree to uphold the Constitution and By-Laws of the Greater Sierra Vista Kennel Club (GSVKC) and abide by its Code of Ethics. I also agree to obey the rules of the American Kennel Club. I affirm that the information I've provided in this application is correct and I grant the GSVKC Board of Directors permission to verify my information.

Signature of Applicant: ________________________________Date: ______________

Signature of Parent or Guardian if applicant is a minor: __________________________

To be completed by Secretary/Membership Chairman:

Date Application submitted: ____________________ Dues Paid: $_______

Date Provisional Membership Started (1^st reading): _______________________

Earliest Possible Date of Final Vote (2^nd reading): __________________

Meeting 1: ______________ Meeting 2: ______________ Meeting 3: ______________

Date of Final Vote (2^nd reading): _______________________

To be completed by two full members of GSVKC in good standing, just prior to 2^nd reading. The provisional member must have completed not less than 6 and no more than 12 months of provisional membership and be attending at least their 3^rd meeting for the 2^nd reading to take place.

We believe that this provisional member should be granted □ Individual □ Junior membership status.

Name: _____________________________ Signature: __________________________ Date: _______________

Name: _____________________________ Signature: __________________________ Date: _______________

To be completed by President after 2^nd reading:

Membership □ Approved □ Disapproved

President: _________________________________________ Date: _________________