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Australian Shepherd Club of Central Florida (ASCOCF)
Membership Application Form
Membership Type
*
New Member Application
Membership Renewal (Include Name, Signature & Renewal Type)
Junior Member Application - Non-voting
Associate Member - Non-voting
Name(s):
*
Address:
*
Address 2:
City:
*
State/Province:
*
Alabama
Alaska
Alberta
Arizona
Arkansas
British Columbia
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
North Carolina
North Dakota
Northwest Territories
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon
Zip/Postal Code:
*
Phone:
*
Email Address:
*
Preferred way to contact
*
Phone
Email
Text
Any
Areas of Interest:
*
Pet
Breeding
Obedience
Conformation
Herding
Search & Rescue
Tracking
Agility
Judging
Handling
Ring Steward
Aussie Rescue
Dock Diving
Barn Hunt
Rally
Member of USASA:
*
Yes
No
Number of Dogs:
*
Breed(s) of dogs owned:
*
Please give a brief history of your dog related activities:
*
Club communications and updates are posted in the Facebook Group ASCOCF-Membership. Please include your Facebook account name so we can add you to the group:
*
If you prefer to receive ASCOCF notifications via email please check here:
*
Email Notification
I agree to abide by the Constitution, By-laws and the Code of Ethics of the
Australian Shepherd Club of Central
Florida
and am in good standing with the
American Kennel Club
Signature of Applicant
*
clear
Signature of Co-Applicant
clear
Kennel Name
Sponsor 1
*
Sponsor 2
*
Memberships are renewed yearly in January. Payment must accompany application (Check or PayPal)
US funds only. Dues are not tax deductible. All new applicants and current members must attend one
General Meeting per year to retain active voting status.
Payment Type:
*
Check
PayPal
Please Check:
*
Individual Membership ($20.00)
Household Membership ($30.00)
Junior Membership - Non-voting ($10.00)
Associate Membership - Non-voting ($10.00)
Memberships are renewed yearly in January. Payment must accompany application (check or PayPal)
US funds only. Dues are not tax deductible. All new applicants and current members must attend one
General Meeting per year to retain active voting status.
“B” Breeder-someone who has registered a litter (AKC) within the past 3 years.
“E” Exhibitor-someone who has handled a dog at an AKC- licensed event within the past 2 years.
Please note in which areas you have handled:
Conformation
Obedience/Rally
Agility
Herding
Other: Please specify
Other: Please specify
“DO” Interested Dog Owner-someone who, although not actively breeding or exhibiting, is a dog owner of an AKC registered dog and is active in the club.
“J” AKC licensed judge