                Member of the
          American Kennel Club

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Membership Application

Statement of Application

I hereby apply for membership in the Clearwater Kennel Club, Inc. I have selected the type of membership that I am interested in and have paid the application fee.

I understand that I must attend three (2) meetings within 6 months. My request for membership in the club will be put to vote at the third meeting I attend.

I agree to abide by the Constitution and By-Laws of the Clearwater Kennel Club, Inc. and the American Kennel Club. I further agree to abide by the Club’s objectives, to support the Club’s mission which is to further the interest in all breeds of pure bred dogs, to do all in it’s power to protect and advance the interest of all breeds of pure bred dogs, to encourage sportsmanlike competition at dog shows and obedience trials under the rules of the American Kennel Club, and to conduct myself in a manner fitting a fancier of purebred dogs.

Type of Membership (check one)

Regular - $25

Associate - $10

Junior (under 18) - $0

Membership Rules

I have read and understand the Statement of Application.

Read the Constitution & By-Laws Here

Governing Rules

I have read, understand, and should I be accepted into the Clearwater Kennel Club, agree to abide by the Constitution and Bylaws and the code of Ethics of the Clearwater Kennel Club. I am currently a member in good standing of the American Kennel Club and all other affiliate clubs that I am a member of.

First Name: *

Last Name: *

Address: *

City: *

State

Zip: *

Phone Number: *

Email: *

Date of Birth: *

Occupation: *

Dog Related Interests (check all that apply)

Conformation

Obedience

Tracking

Field Work

Agility

Rally

Lure Coursing

Community Service

Therapy Dog Demos

Breeder Status

I have been a breeder in the past.

I am currently a breeder

I am interested in being a breeder in the future.

If a current breeder, how many litters a year do you have?:

If a current breeder, do you sell to a broker?

Yes

No

Committees you would like to be part of (check all that apply)

Conformation

Obedience

Performace

Sunshine

Hospitality

Membership

Education

Marketing / Fund Raising

Grounds / Equipment

Membership Participation in Club Events

Have you ever belonged to a kennel or specialty club?

Yes

No

Are you currently a member of a kennel or specialty club?

Yes

No

Do you currently hold a board or officer position in another kennel or specialty club?

Yes

No

Have you ever been suspended or expelled from or refused membership in an AKC club?

Yes

No

Are you currently in good standing with the AKC?

Yes

No

Do you own an AKC recognized breed?

Yes

No

If yes, which breed(s)?:

How many years have you owned a pure breed dog?:

Do you currently participate in any AKC sports or activities?

Yes

No

If yes, which AKC sports or activities?

What do you hope to gain by becoming a member of the Clearwater Kennel Club?

I agree to be active in promoting the WVKC All-Breed Dog Shows which are held yearly and other activities conducted by the Clearwater Kennel Club.

Signature

Electronic Signature

Today's Date

Today's Date

Sponsor #1

Sponsor #2

Voting on this application occurs after the second reading of this application and requires a 75% majority of the members present to vote in favor.

Reading #1

Reading #2

Payment via Pay Pal addressed to clearwaterkennelclub@gmail.com

Payment via Check: make payable to Clearwater Kennel Club. Mail addressed to the Treasurer listed below.

Attention: Dan Stolz
180 Motor Rd.
Lexington NC, 27295

After you submit the form, you will be directed to a page to pay your membership fees.

2023 Officers
President: Karen Toth
Vice President: Carol Blancato
Secretary: Judy McDougall
Corresponding Secretary: Ron Ronald
Treasurer: Daniel Stolz
3 Year Board Member: Sanda Kruger
2 Year Board Member: Mary Stolz
1 Year Board Member: Shirl Fisher

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