Membership Application/Renewal
Name: _______________________________________ Date: ________________________
Address: ___________________________________________________________________
City: ______________________________ Province: _______ Postal Code: ______________
Email: ___________________________________________________
Phone: ________________________ (Work/Home/Cell)
Canadian Kennel Club membership number (if applicable): ___________________________
Kennel Name (if applicable): ___________________________________________________
Breeder/Owner member (y/n): ____ Pet Owner member(y/n): _____
Membership: New Member: ____ Renewal: _____
Single Member ($20.00): ______________ Family ($25.00): __________________
Donation: __________________
Do you have time/interest in volunteering at club events: Yes: _________ No: ___________
Please make cheque payable to “Manitoba & North Western Ontario Dachshund Club” and send to:
Shauna McLauchlan OR E-transfer to: [email protected]
Secretary/Treasurer (Include note to indicate club membership application/renewal)
Box 5, Group 130, RR 1
Beausejour, MB R0E 0C0