Jersey Skylands Labrador Retriever Club, Inc. – Membership Application

Membership Type

Individual Membership – $25 Annual Dues

Household Membership – $40 Annual Dues

Club year runs September 1 through August 31. Applicants voted in on or after April 1 are paid through the following club year.

First name

Last name

Home Phone

Mobile Phone

Email

Multi-line address

Country/Region

Address

City

Zip / Postal code

Occupation

Kennel Name

Website

Additional Household Member Name

Relationship to Applicant

Additional Household Member Email

Additional Household Member Phone

Dogs Owned or Co-Owned - For each entry: Dog Name, AKC Registration Number, Breed

Other Club Memberships - Please include Club Name, Offices Held, Dates Held

I am willing to be the Chairperson of

I am willing to work on the following committees

Brief history of your involvement with dogs and reasons for joining the club

Sponsors must be current JSLRC members in good standing.

Sponsor Letter of recommendation

I understand that annual dues are $25 for Individual Membership or $40 for Household Membership and are required for processing this application

I have read and agree to abide by the Club’s Constitution, By-Laws, Policies, and Code of Ethics

Signature

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Date

Month

Day

Year

Additional Household Member Signature (if applicable)

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Date

Month

Day

Year