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MEMBERSHIP APPLICATION

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NAME: (Mr, Mrs, Miss, Ms)  
ADDRESS 1:  
ADDRESS 2:  
POSTCODE:  
TELEPHONE:   EMAIL:  

I/We wish to apply for membership of the Southern Border Collie Club.
My/Our application is proposed and seconded by the following Club members:

PROPOSER** NAME:  
ADDRESS:  
SIGNATURE:
 
 
SECONDER** NAME:  
ADDRESS:  
SIGNATURE:
 
 

I/We understand that the objectives of the club are:
"To preserve the working attributes of the breed, to encourage responsible ownership, to endeavour to safeguard the Breed from exploitation by Breeders, and the promotion, general care and well-being of the Breed both on the field and in the show ring".

I/We agree to abide by the Rules of the Club as printed or amended from time to time.

Membership Fees: Single £7.00 ~*~ Joint £10.00 ~*~ Family (incl. 2 adults) £12.00 ~*~ Junior (under 18 years) £4.00

I/We agree to our name/s and address being held on a computer file & submitted to the Kennel Club.
I/We enclose a cheque/postal order (payable to SBCC) or cash to the value of £.........................

SIGNATURE........................................................................ DATE:......................

Please indicate your interests with a circle:
Breed ~ Obedience ~ Agility ~ Working Trials ~ Sheep Working ~ Other Interests

Please would you write a short history of your interest/experience in the breed overleaf, including levels at which you work your dog or judge, if applicable. Please give details of any clubs or societies to which you belong.

**If you do not have a proposer and/or seconder, these may be provided for you.

Completed forms and fees should be sent to the Membership Secretary:
Melanie Lewis, Long Grove, Altona Road, Loudwater, High Wycombe, Bucks HP10 9R.

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