MEMBERSHIP APPLICATION FORM
(Financial year 1st September to 31st August each year)
To be sent together with your cheque or postal order to:
| The Treasurer : | Mr M. Calderwood or | The Secretary | Mrs C. Curnick |
| PO Box 218 | 590 Atkins Road | ||
| LANCEFIELD Vic 3435 | WURDIBOLUC Vic 3241 |
NAME........................................................................................................................................
(Please print clearly)
ADDRESS..................................................................................................................................
POST CODE............
TELEPHONE........................................ VCA MEMBERSHIP NO.............................................
E-MAIL................................................................
Kennel Prefix (if applicable)...............................................................
YES / NO (I would like my Phone number to be included on the Breeders Index on the Clubs Website)
| Joining Fee | $ 5.00 |
| Single | $15.00 |
| Dual | $20.00 |
| Junior | $ 5.00 (up to 16 years) |
| Breeders Index | $10.00 |
| BCOV Website Listing | $10.00 |
| UK , USA , Europe | AUST $15.00 |
| New Zealand | AUST $10.00 |
In the event of my/our admission as member/s in the above category, I/we agree to be bound by the rules & By-Laws of the Club and the Constitution, Rules and Regulations of the V.C.A. for the time being in force.
SIGNATURE OF APPLICANT/S............................................................................
DATE...................................................................