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MEMBERSHIP APPLICATION



PLEASE COMPLETE AS FULLY AS POSSIBLE IN BLOCK CAPITALS



Name: Mr / Mrs /Miss. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Address:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Post Code:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Phone Number:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Email:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Affix ( if applicable ):. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If possible your application should be supported by two members.
Proposer: . . . . . . . . . . . . . . . . . . . .Seconder: . . . . . . . . . . . . . . . . . . . .
PLEASE STATE:
How many dogs do you have:
What breeds:
How many litters a year do you breed:
Who recommended you to this club:
Are you a Member of any other Cairn Club ( if so please state the club ):


Membership Fees

Single/Joint : 10.00     Triple/Quad/Overseas : 16.00      Joining Fee ; 1.00 Per Person.

Payment at time of Application and due annually on January 1st thereafter.

All Applications to be confirmed by the Committee.

All Applicants must agree to adhere to the Cairn Terrier Breeders code of conduct.

Signature of Applicant(s): . . . . . . . . . . . . . . . . . . . .Date: . . . . . . . . . . . . . . . . . . . .