RARITAN VALLEY AUSTRALIAN TERRIER CLUB
Membership Application
Date______________
Are you 18 years of age or older? _________________
Name___________________________________________________________
Address_________________________________________________________
__________________________________________________________
Telephone No. Home:___________________ Work:______________________
Fax No._______________________________ Email Address: _______________________
Experience in Dogs______________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Other Dog Club Memberships______________________________________________________
______________________________________________________________________________
Skills and Talents that might benefit the Club: _________________________________________
Are you in good standing with the AKC? _______________
Have you AKC privileges ever been suspended? _____________
I hereby agree to abide by the rules of the AKC and the constitution and by-laws of the Raritan Valley Australian Terrier Club.
______________________________
Signature of applicant
_____________________________________________
_____________________________________________
Signature of sponsor Signature of co-sponsor
Mail application and $10.00 membership fee to:
Kerrie Bryan, Secretary 1060 E. Park Ave.
Vineland, NJ 08360-3332