03/17/08

Date:                                       

Please check one:

Renewal:____    New Member:____

Please check one:

Membership: Family ($25.00)_______

Individual ($20.00) ________

Name:_____________________________________

        Spouse:_____________________________

        Children:____________________________

Address:___________________________________

        City ____________________Zip:_________

Phone:____________________________________

E-Mail:____________________________________

DOGS (Please include titles With Name)

______________________________________Breed___________

______________________________________Breed___________

______________________________________Breed___________

______________________________________Breed___________

______________________________________Breed___________

______________________________________Breed___________

I can be called to help with:

___ Hunt Tests

        __ Marshaling

        __ Planting, Placing, Throwing Birds

        __ Gunning (must have gun safety course)

        __ General Worker Bee

___ Raffle

___ Barbecue

___ Club Training Days

___ Fund Raising

___ Club Demonstrations

___ Service Projects

I would be willing to service on:

___ The Board

___ Hunt Test Committee

___ As A Club Officer

I am interested in:

___ Training ___ Competition ___ Judging