Blue Grass Parson Russell Terrier Club

 Membership Application

 

NAME_____________________________________________________________________________

ADDRESS _________________________________________________________________________

CITY_________________________________________STATE___________ZIP__________________

 PHONE________________________E-MAIL______________________________________________

OCCUPATION_______________________________________________________________________

KENNEL NAME _____________________________________________________________________


Primary interest(s) in dogs:

Exhibiting           Working           Agility          Companion             Rescue

Obedience          Breeding        Earth Dog            Other     

Breeds presently owned __________________________________________________________________

Number of dogs presently owned __________________________________________________________

List the Dog clubs to which you belong/have belonged and offices held and Reasons for leaving   

_____________________________________________________
___________________________________

________________________________________________________________________________________

________________________________________________________________________________________

Are you presently in good standing with your Breed Club?________________________________________

  I am willing to participate on a committee where my services can be of benefit to the Club ______________

 I agree to abide by the Constitution and By-laws of BGPRTC, Inc.__________________________________

 Signature_______________________________________________________ Date ____________________

      Dues: $ 25.00- Single __________ $30.00- Family ____________

  
Make checks payable to: BGPRTC

               
Mail to: Cathy Greenfield 10250 Woodbury Rd. Laingsburg, Mi 48848