| AMERICAN BLACK AND TAN COONHOUND CLUB, INC. |
| MEMBERSHIP APPLICATION |
| Page2 |
TYPE OF MEMBERSHIP APPLIED FOR:
| INDIVIDUAL ______ |
HOUSEHOLD _____ |
JUNIOR (Jr's date of birth)___ |
NAME
_______________________________________________________________
NAME _______________________________________________________________
FAMILY MEMBERS AND AGES _________________________________________
MAIL ADDRESS ______________________________________________________
| Black and Tan Coonhounds currently owned: |
| registered name |
Call name |
AKC # |
Other breeds owned and number
Have you bred and registered any litters within the past three years?
Yes____ No____
Have you exhibited at AKC approved events within the past two years?
Yes____ No____
Are you an AKC approved judge? Yes____ No____
Briefly describe your interest in purebred dogs, as well as any other hobbies or interests that would be of use in club activities?
Briefly list your dog-related affiliations (kennel club, obedience club, etc.) and any positions held:
| Applicant's signature/Date ____________________________________________________ |
|
|
| AB&TCC Sponsor Signature/Date
_____________________________________________ |
|
|
| AB&TCC Sponsor Signature/Date
_____________________________________________ |
(Revised 10/2007)
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