Northern Virginia Collie Club

Membership

Download the membership application in MS Word or PDF format.

I hereby make application for membership in the Northern Virginia Collie Club. I agree to abide by the bylaws of the club and the Code of Ethics of the CCA and to conscientiously promote the interest in Northern Virginia Collie Club to the best of my ability.

Dues: $15.00 annual fee due on November 1 each year. Couples $25.00
Make all checks payable to Northern Virginia Collie Club

Applicant’s Information:

Name: ____________________________________________

Address:____________________________________________

City, State, Zip______________________________________

Email address: ________________________________________

Phone: (H)___________________(W)__________________Cell_________

Occupation: ____________________________________________

How long in Collies ______________ Number of dogs ________________

Number of Collies ______________________

What made you interested in collies? _______________________________________

_______________________________________________________________

Do you breed? ________________ Number of litters/yr _________________

Do you show in conformation/performance? ________________

If yes, which events do you participate? ____________________________

Do you participate in non-AKC activities? ______________________

If yes, which ones?__________________________________

Do you do therapy work with your dog? __________________________

Do you have children interested in junior handling ________________

Other Hobbies___________________________________

What activities would you like to participate in (match planning, show planning, education, other) ___________________________________

CCA member ?________________

Other clubs that you belong to?_____________________________________

By joining NVCC what do you hope to learn? ____________________________

What activities would you like to see the club offer?_____________________________

Referred by: _____________________________

Sponsor Signature ______________________

Applicant’s signature_________________________ Date: ________________

___________________________________________________________________________

For Official Use Only:

First Reading_________________ Second Reading _________________

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