Feather River Australian Shepherd Club

Membership Application

___ Single Membership (1 vote) $ 15.00

___ Dual voting Membership (2 votes)  $20.00

___ Junior Membership (no vote) $5.00

(Please see copy of By-Laws under Article II Membership for a description of Memberships)

Name(s) ___________________________________________________________________________
Address ___________________________________________________________________________
City/Prov/Postal Code ________________________________________________________________
Phone (_____)___________________________ Fax (_____)___________________________
Email ____________________________________________________
Kennel Name _________________________________________________________________

AREAS OF INTEREST (circle all that apply)

Pet        Breeding        Obedience         Conformation        Herding

Agility        Tracking         Flyball        Fund raising    

Aussie Rescue       Ring stewarding         Handling

Other ____________________________________________________
Are you active in any of the above areas ?    YES     NO
Number of Aussies you own _______ Number of dogs in total ________

List other breeds _____________________________________________

I agree that I/we am/are in good standing with the Australian Shepherd Club of America.

Signature of Applicant _______________________________________________

Signature of Co-Applicant ____________________________________________

Please print this page and mail, with your payment, to the Treasurer at:

Allen Renville, Treasurer
Feather River Australian Shepherd Club
2554 Lakehills Drive
Butte Valley, CA  95965