Membership Application

Name:______________________________________________________________________

Address:__________________________________________________________________

City:_______________________________Postal Code:__________________________

Phone (with Area Code) :___________________E-Mail__________________________

Kennel Name:______________________________________________________________

Breed Variety:_____________________________________________________________

Colors:____________________________________________________________________

Website:___________________________________________________________________

Tattoo Series:___________________C.K.C Number___________________________

ensure you have two sponsors before mailing your application :

Sponsored By:_____________________________________________________________

Second Sponsor:_________________________________________________________

please tell the club something about yourself and why you want to

be a member

_____________________________________________________________________________________

What activities do you participate in with your poodle ?

conformation ______ obedience _______ Agility ______ Other ___________

I/We hereby agree to abide by the constitution, By-laws and Code of Ethics set forth by the Poodle Club of Canada. The Poodle Club of Canada has the right to decline any membership application that does not meet its requirements.

Signature________________________________________Date : ___________________

Membership Fee:

Individual $40.00,Couple $50.00, Junior $7.00

Please send your application form and cheque to:

Diane Welsh

10246 Old Shiloh Road

Pefferlaw, Ontario

L0E 1N0