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CANADIAN ESKIMO DOG CLUB OF |
MEMBERSHIP FORM 2008
NAME:
_________________________________________________________________________________
ADDRESS: _____________________________________________________________________________
CITY/TOWN:
______________________________________________________________________
PROVINCE/STATE:
__________________________ COUNTRY: ____________________________
POSTAL/ZIP CODE:
_________________________ PHONE NUMBER: ( ) _____________
WORK NUMBER: (_____)___________ FAX NO:
(_____)____________
EMAIL ADDRESS:
________________________________________________
KENNEL NAME: __________________________________________________
ADDITIONAL MEMBERS IN SAME HOUSEHOLD:
- ______________________________________________________________
- ______________________________________________________________
- ______________________________________________________________
OTHER CLUB AFFILIATIONS:
- ______________________________________________________________
- ______________________________________________________________
- ______________________________________________________________
(Additional information if necessary)
MEMBERSHIP
FEE
|
PRIMARY
EACH ADDITIONAL
HOUSEHOLD MEMBER
NON-CANADIAN
RESIDENT |
$50.00
$25.00
$50.00
|
*Please note: All fees are payable by cheque or money order issued through a Canadian Banking Instution
or purchased in U.S funds for the full amount. Cheque's marked “payable in Canadian funds” will not clear our
banks,
and no discounted Cheque's will be accepted.
**Please
make Cheque's payable to the Canadian Eskimo Dog Club of Canada, and mail along
with completed form to:
CODEC C/O Laura Pitblado,
115 Con. 4
& 5 E, RR #2,
Canada P1H 2J3
***NSF Cheque's are considered non-payment, and the application will not be processed until bank charges
of
$30 plus the membership fees are made good via money order or certified cheque.
I
hereby agree to the policies set forth by the Canadian Eskimo Dog Club of
Member’s
Signature: _____________________________________________
