SPINONE CLUB OF AMERICA    

SpinoneClubOfAmerica.com
The AKC Parent Club

 
 
 
 
 

SPINONE CLUB OF AMERICA, INC.
MEMBERSHIP APPLICATION:   (Circle One)     NEW      RENEWAL

Your Name:
______________________________ Spouse/
Partner:
______________________________

Address1:
______________________________    

Address2:
______________________________    

City:
______________________________
Phone:
______________________________

State:
________Zip:___________________
E-mail:

______________________________
Member Sponsor: ______________________________    


Your name, address, phone number and email address will appear on a membership list that is available to club members.


 

*I Own _____ Spinone(i):  ____Female(s)    ____Male(s)


Dog's:
Name

_________________________
Reg. No.

____________
Color

____________
Whelping Date

____________

 
_________________________ ____________ ____________ ____________

 
_________________________ ____________ ____________ ____________
For additional dogs, include a second sheet with the above information for each dog

Please indicate how you wish to receive future newsletters (circle one):

Postal Mail (add $5 below)      Website       Email (please submit your e-mail address)

___________________________________________________________________________________________________________________________

I AM ENCLOSING:

Single Membership:................................................... $35.00/year.............$_______________

Family Membership:................................................... $40.00/year.............$_______________

Outside the U.S......write U.S. Funds on Check............add: $ 5.00/year........$_______________

Postal Delivery of Newsletter......................................add: $ 5.00/year........$_______________

TOTAL ENCLOSED......................................................................................$_______________

 

_______________________________________________________________________________________
Signature                      Date of Application/Renewal

Send Application and Check to:

Kim Vanderbilt
SCOA Membership Secretary
P.O. Box 1223
Old Chelsea Station
New York, NY 10113

___________________________________________________________________________________________________________________________

Code of Conduct of the
Spinone Club of America

Approved: April 1994
Amended: May 1996 & 2001 and April 2002, 2003, 2005, 2008, 2009 and 2010

 

_______________________________________________________________________________________
Signature              Date of Application/Renewal

All information is deemed reliable, but is neither guaranteed nor independently verified.
Copyright © 2009 – Spinone Club of America, Inc. All Rights Reserved.