The Rhodesian Ridgeback Club
of
Eastern Canada

MEMBERSHIP FORM – 2011
Membership dues are non-refundable

$35.00 FAMILY : includes 2 votes
$25.00 SINGLE : includes 1 vote
$35.00 OUTSIDE CANADA
LIFE MEMBER

New Member Application

Renewal

This section to be completed by Breeder Sponsor only

Breeder Name

Kennel Name

Payment Choices

PAYPAL - Paypal users must include a $1.32 processing fee.

BANK TRANSFER - I will be paying my 2011 membership fee using a bank transfer.

CHECK - I will be paying my 2011 membership fee by check.

LIFE MEMBER - I am completing my annual registration information.

Membership Information

 First Name *

 Last Name *

 Spouse First Name

 Spouse Last Name

 Street Address *

 City *

 Province *

 Postal Code *

 Country

 Email Address *

 Home Phone *

 Today's Date

The following information is helpful in planning club events. Please take a moment to complete the following:

 
FAMILY MEMBERS : # of Adults * # of Children

 
I / We are interested in (Check items which apply) :

We would appreciate your input and feedback!

1. This is your club and it is only as good as you make it. Can we call on you to help out with the organization and/or operation of club activities and events in your area?
    YES *        NO

If yes, what expertise / skills are you able to volunteer in assisting the club's Executive in providing activities and services to it's members.

2. Are you a member of the CKC?     YES *        NO                  

                                                                                                                            CKC Number