TAR HEEL CHINESE CRESTED CLUB

Membership Application

Single ($25.00)

Household ($40.00)

Associate (15.00)

Please enter information before printing:
Name(s):
Address:

City:

State:

Zip:

Phone:

Fax:

E-Mail:

Web Site:

Kennel Name:

Occupation:

Do you presently own a Chinese Crested?:

How many do you have?:

When did you aquire your first Chinese Crested?:

Please indicate your main interests by checking one or more of the following:
Breeder	Exhibitor	Handler	Obedience	Agility	Pet Owner	Rescue

Other

List other breeds you breed or show:

List all dog clubs you belong to and offices you have held - (i.e.,All-Breed, Specialty, Breed, Obedience, Agility, Etc.)
Have you ever been suspended from the AKC or any other Dog Club?
If yes, please explain on a separate sheet of paper and include with your application.

Please list any other interests or talents you have that you feel can contribute to the Club.

Two THCCC Club Members (In good standing for no less than one year) are required to be your sponsors in order for your application to be considered.

I, THE UNDERSIGNED, hereby apply for membership in the Tar Heel Chinese Crestes Club, and certify that I am at least 18 years of are. I agree to abide by the Constitution and By-Laws of the Tar Heel Cinese Crested Club Inc. and by the rules and regulations of the American Kennel Club. I hereby certify that I am in good standing with the American Kennel Club. Should my application be denined, the Club is not obligated to make the reason known.

Signature of applicant(s):

Date:

SPONSORS:
I am personally acquainted with this applicant(s) and recommend his/her/them for membershipand agree to act as their sponsor.

Sponsor 1
Name:		Signature

Address:

Sponsor 2
Name:		Signature

Address:

Please return this application and a check or money order make payable to Tar Heel Chinese Crested Club by mail to:

Tar Heel Chinese Crested Club
c/o Barry L. Holt
491 Reeder Branch Dr.
Clayton, NC 27520-4021

For Club use only (do not write in this space)
Check #	Accepted	Date
Cash	Pending	Date
Money Order	Denied	Date

Notes: