APPLICATION FOR MEMBERSHIP
Name
Address E-mail
City State Zip
Phone Occupation
Membership Type (Regular or Associate)
---------------------------------------------------------------------------------------------------------------------------------
PUG BREEDING
ACTIVITY
Approximate number of litters bred in the last 3 years:
If list is too short, use a random sample of litters.
LITTER REGISTRATION
NUMBER
WHELPING DATE
---------------------------------------------------------------------------------------------------------------------------------
EXHIBITING ACTIVITY
Approximate number of licensed events exhibited in the last 2 years:
If list is too short, use a random sample of shows in which you participated.
EXHIBITING
ACTIVITY
EXHIBITING ACTIVITY
------------------------------------------------------------------------------------------------------------
PUGS CURRENTLY OWNED
Number of pugs owned:
If list is too short, use a random sample of dogs.
REGISTERED NAME REGISTRATION
NUMBER
------------------------------------------------------------------------------------------------------------
CLUB
INFORMATION
I wish to join the
Northern California Pug Club because
I agree to abide by the rules of the American Kennel Club. I have received and/or have read the Code of Ethics and the By-Laws of the Northern California Pug Club and agree to abide by these. I am in good standing with the American Kennel Club.
Date: Signature:
Club dues are twenty five dollars
($25.00) per person per year for regular membership and twenty dollars ($20.00) per person per
year for associate membership. Your first year’s dues payment must accompany this
application. New members who have
paid dues during the last quarter of the year will be credited for a paid
membership for that quarter and the next year. Otherwise, annual dues are
payable on January 1st of each year.
Please make checks payable to: NCPC
Mail your application to:
Jim Williams – NCPC Membership Chairman
6216 Radiant Drive
San Jose, CA 95123-4852
If you have any
questions, you can contact Jim at (408) 629-9366 or via email at radiantpugs@comcast.net
---------------------------------------------------------------------------------------------------------------------------------
THE
FOLLOWING ADDITIONAL INFORMATION IS REQUIRED FOR APPLICATION AS A “REGULAR”
CLUB MEMBER ONLY
CLUB ACTIVITIES
To apply for Regular membership you must attend one meeting and either work at one NCPC function or attend a second meeting; all within one year of submitting your application for membership. You must sign the meeting roster sheet.
Date of first
meeting attended:
Date of second meeting or NCPC function worked:
If you worked at a function, please complete the following:
1) Job done:
2) Person who assigned the job to you:
SPONSORS
The following is required for Regular
membership only, and must be completed by two (2) sponsor NCPC members in good
standing.
I believe the above applicant will benefit from membership in the Northern California Pug Club and can contribute both to the pug breed and NCPC. I know and recommend this applicant for membership.
Date ___________________ Signature ____________________________________________________
Date ___________________ Signature ____________________________________________________