CHINESE CRESTED DOG CLUB OF NSW

APPLICATION FOR MEMBERSHIP/RENEWAL/CHANGE OF ADDRESS

Annual Subscription: Dual $20.00     Single $15.00     Pensioner $10.00     Junior Free/ $10.00 with Newsletter (Tick one)

Annual Subscriptions are due and payable by 30th June each year.

I/We hereby apply for membership/renewal/change of address of the Chinese Crested Dog Club of NSW and agree to abide by the Club’s Constitution and the Rules and Regulations of the Royal New South Wales Canine Council Ltd. (Trading as Dogs NSW)

PLEASE PRINT

Postcode                 Telephone (____) ______ _______________

Email_______________________________________________

Junior Members     Name                                     Date of Birth        /        /       

                              Name                                     Date of Birth        /        /       

Signature/s of Applicant/s ____ ________________________________________________________(Dual Membership both must sign)

Proposed by                                                         Seconded by                                                       

Please return to Club’s Secretary:  Chinese Crested Dog Club of NSW Miss S Pickering PO Box 3007 BOWENFELS NSW 2790

Date Accepted:       /        /       President_____________________________________________

APPLICATION IS SUBJECT TO RATIFICATION AT THE NEXT CHINESE CRESTED DOG CLUB OF NSW GENERAL MEETING