COLUMBIA KENNEL CLUB INC.
Application for Membership

 

Instructions:  Please complete and submit this form to the CKC Secretary along with a check for one year’s dues made payable to Columbia Kennel Club, Inc.  Applicant(s) must attend at least two club meetings within a four-month period.  The Vice President will read this application at the next two consecutive meetings.  Following the second reading, the membership will vote upon the application.  Written notification of membership status will be sent by the Secretary.  Deposit of check does not constitute membership and money will be refunded if the application is not accepted.

 

Membership definitions:

            Family or couple = Husband and wife or two members residing in the same household

            Individual = Only one member of the household

            Junior = Ages10 through 18 (excludes voting privileges)

 

Indicate membership type:

            Family/Couple ($25) _____             Individual ($15) _____            Junior ($10) _____

 

Please print clearly:

 

 

Name                                                                                                  email

 

Home Phone               Work Phone                                Cell Phone

 

Address                                                                           City, State, Zip

 

Occupation                                                                      Employer


Co-Applicant

 

Name                                                                                                   email

 

Occupation                                                                      Employer

 

Kennel Name

 

Please list all breeds, number of dogs presently owned, and litters registered within the past five years:

 

Breed                                                                      # of Dogs                       # of Litters

Breed                                                                      # of Dogs                       # of Litters

Breed                                                                      # of Dogs                       # of Litters

 

 

 

CKC Secretary only
Meetings attended to qualify for membership:


Meeting One on _____/_____/_____                                     Meeting Two on _____/_____/_____

 

What benefits do you think CKC has to offer you?

 

 

 

What benefits to you think you have to offer CKC?

 

 

 

List names & dates of members to other dog clubs to which you belong:

 

 

 

 

Have you ever been suspended by AKC?________  If so, list reason and date:

 

 

 


The applicant(s) give authorization to Columbia Kennel Club, Inc. to verify all information provided on this form to be true and correct.  The applicant(s) agree to abide by the Constitution and By-Laws of Columbia Kennel Club, Inc. if membership is approved.

 

 

Applicant Signature                                                                 Date

 

 

Co-Applicant Signature                                                           Date

 

 

 

ENDORSEMENTS

 

We, the undersigned, do endorse the applicant(s) listed on this form and, to the best of our knowledge, find the individual(s) to be ethical and potential assets to the Club.

 

 

Signature of Member                                                              Date

 

 

Signature of Member                                                               Date

 

 

 

CKC Vice President only
Meetings attended to qualify for membership:


First Reading on _____/_____/_____            Second Reading on _____/_____/_____

 

Application was approved / denied on _____/_____/_____