Membership Application

Rockford-Freeport Illinois Kennel Club*
Membership Application
Name: ____________________________________ Occupation: ________________________________
Address: _______________________________________________________________________________
Home Phone #: __________________________ Office Phone #: ________________________________
E-Mail Address: ________________________________________________________________________
Number of Registered Dogs: _________ Breeds: ___________________________________________

Please answer Yes or No to the following Questions:	Yes	No
Do you breed dogs?
Do you offer stud service?
Do you sell puppies?
Do you show any of your own dogs?
Do you show any dogs for someone else?
Do you intend to show in the future?
Do obedience or performance classes interest you?
Do you groom for others?
Are you able to attend monthly club meetings?

Why do you want to be a member of this club? ____________________________________________________________________

___________________________________________________________________________________________________________.

Do you have any experience in Conformation, Obedience, Performance Training, Judging, or any other dog related activities?

__________________________________________________________________________________________________________.

Do you have any talents, not necessarily related to dogs that you would be willing to use as a member of this club? ____________

__________________________________________________________________________________________________________.

Have you ever had AKC Privileges denied, revoked, or suspended? (If yes, please explain? ______________________________

__________________________________________________________________________________________________________.

List all kennel clubs in which you have held membership and the number of years: ______________________________________

_________________________________________________________________________________________________________

Specify membership desired: Single ($7/yr) _____________ or Family ($10/yr) ______________
A one time $20.00 Membership fee must be included with this application.
Then going forward, All member dues are payable on or before December 31, of the current year for the next year.

I/We agree to abide by the constitution and By-Laws of the Club, the rules of the American Kennel Club, and will not sell litters or
individual dogs to pet shops or deal in litter sales.

I/We understand if I/We are accepted as a member(s), I/We will enjoy all the benefits of the Club and in return will be active in club
activities, which includes attendance of regular meetings and acceptance of responsibility and committee work when the occasion
arises.

I/We understand that the Club also reserves the right to inspect any and all kennel properties owned by me if they so desir, before
accepting me as a member.

Applicant(s) Signature __________________________________________________________________

Sponsoring Members Signature __________________________________________________________

Application returned to club on ________________ Accepted: ____ Denied: ____ Date: ___________
* Rockford-Freeport Illinois Kennel Club website: http://www.rockford-freeportillinoiskennelclub.org