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Membership period 1st September 2010 to 31st August 2011
Name........................................................................................
Address.....................................................................................
................................................Post Code.....................
Telephone................................. Kennel Prefix
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FROM DECEMBER 2010 THE CLUB NEWSLETTER WILL BE DISTRIBUTED VIA E-MAIL
UNLESS REQUESTED OTHERWISE
PLEASE SUPPLY YOUR E-MAIL ADDRESS FOR US TO UP DATE OUR MAILING LIST RECORDS
Email………………………………………….....................
( ) I prefer to receive my newsletter via post
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Membership categories (Please Tick)
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VCA Member Dual/ Kennel Membership
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VCA Member Single Membership
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* Non VCA Dual/ Kennel Membership
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* Non VCA Single Membership
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( ) Fee $25
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( ) Fee $20
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( ) Fee $40
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( ) Fee $27.50
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I am most interested in:
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Field and Retrieving Trials
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Shows
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Obedience
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Training Days
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Helping at Club Events
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Committee
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Are you a member of the Victorian Canine Association? YES / NO (Please circle)
If you answered yes to the above question, please state your VCA Membership
Number ................................
*Please note: Non Members of the VCA must incur further charges collected on behalf of the VCA to cover insurance for the membership period.
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RETURN COMPLETED FORM WITH FEES TO:-
THE TREASURER
Mrs. Seleena Nichols
Post Office Box 759
Mt Eliza 3930
Cheques made payable to: The German Shorthaired Pointer Club of Victoria Inc
SIGNATURE OF APPLICANT..........................................................
DATED.................................................
I AGREE TO BE BOUND BY THE RULES OF THE CLUB FOR THE TIME BEING IN FORCE.
***Membership subject to Committee Approval***
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TREASURER'S/SECRETARY'S USE ONLY:-
Reference No........................... Date Membership Processed.................................
Link to a PDF file for the Renewal Form
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