• North Country Kennel Club, Inc. 47 Hardscrabble Rd. Port Jervis, NY 12771 northcountrykennelclub@gmail.com

Application For Membership
The undersigned, wishing to become a member of the North Country Kennel Club agree to uphold the Constitution and By-Laws of said club, and agree to the following condition   

   I AGREE NOT TO SELL DOGS TO PET SHOPS, OR TO SELL DOGS WHOLESALE.


Name of Applicant(s): ___________________________________________________________
Occupation:                  ___________________________________________________________
Employer:                      ___________________________________________________________
Residence Address:     ___________________________________________________________

( and mailing address if different) ________________________________________________
Phone Number:           ____________________________________________________________
Email Address:             ____________________________________________________________
Breed(s) in which you are interested: _____________________________________________
Are you interested in showing dogs? ______________________________________________
Are you going to breed purebred dogs? ___________________________________________
Do you buy dogs for resale? If yes, please explain: ________________________________
Do you plan to be an active member and attend meetings? _______________________
State reasons for wishing to become a member: _____________________________________________________________________________________
I, the undersigned, understand that the North Country Kennel Club reserves the right to accept or reject this application without recourse or reason.


Signature of Applicant(s): __________________________________________________________
Recommended by:

1. ___________________________________________________________________________________

2.____________________________________________________________________________________
Annual dues to accompany application. Single $20.00; Family $30.00 ______________________________________________________________________________________________________________________________________________________________________________________________________________

Application received on: ________________________

Elected or Rejected on:   ________________________

1st meeting attendance date: ___________________ 

2nd meeting attendance date: __________________

3rd meeting attendance date: ___________________