Application for Membership

Your details

Your Address

Title (Mr, Mrs etc)

House number or name:

First Name:

Address:

Last Name:

Email:

Town/City:

Tel:†

County:

Mobile:†

Postcode:

† We ask for your contact phone number(s) in case any of our events or walks have to be cancelled due to weather conditions or other reasons beyond our control. Your telephone number(s) will not be used for any reason other than for Club purposes and will not be revealed to third parties.

Details of your dog(s)

Number of GSDs owned:

0 1 2 3

Dog's name:

Gender:

Age of dog:

Dog's Birthday

- Male Female

- 0-3 months 3-6 months 6-9 months 9-12 months 1+ years 2+ years 3+ years 4+ years 5+ years 6+ years 7+ years 8+ years 9+ years 10+ years

- 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th 13th 14th 15th 16th 17th 18th 19th 20th 21st 22nd 23rd 24th 25th 26th 27th 28th 29th 30th 31st

- Male Female

- 0-3 months 3-6 months 6-9 months 9-12 months 1+ years 2+ years 3+ years 4+ years 5+ years 6+ years 7+ years 8+ years 9+ years 10+ years

- 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th 13th 14th 15th 16th 17th 18th 19th 20th 21st 22nd 23rd 24th 25th 26th 27th 28th 29th 30th 31st

- Male Female

- 0-3 months 3-6 months 6-9 months 9-12 months 1+ years 2+ years 3+ years 4+ years 5+ years 6+ years 7+ years 8+ years 9+ years 10+ years

- 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th 13th 14th 15th 16th 17th 18th 19th 20th 21st 22nd 23rd 24th 25th 26th 27th 28th 29th 30th 31st

More than three GSDs? Please provide details:

Do you have any skills or resources that could assist the club? If so, please provide details:

How did you hear about us?

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