Return the application, the two sponsors questionnaires and the non-returnable
$15.00 fee to:
Carol Jordan
604 Old Fritztown Road
Reading, PA 19607-1016
Type of Membership: Regular [ ], Dual [ ], Junior [ ]
Name:
Address:
Kennel name (if any):
Phone (H):
Phone (W):
Fax number:
E-mail address:
Occupation:
Sponsor Number One:
Sponsor Number Two:
1. Please give the reason(s) why you wish to join the NNTC:
2. List experiences or talents that could help the Club
and/or its committees:
3. Check at least 3 committees on which you would like to serve:
Education [ ],
Health-Genetics [ ],
Newsletter [ ],
Obedience [ ],
Show Trophies [ ],
Ways and Means [ ],
Working Terriers [ ] , NNTC Web site [ ]
4. When did you first acquire your (circle) Norwich/Norfolk?
5. List all Norwich/Norfolk you have owned, currently own and/or co-own, including registration name and number.
Name / Number / Breeder / Co-owner
6. In addition to Norwich/Norfolk, I own (or have owned)
the following breeds of dogs:
7. If you breed, how many litters of (circle) Norwich/Norfolk have
you bred? (Give dates)
8. Describe in detail how your dogs are housed and maintained:
9. Are you now or have you ever been a member of any breed, kennel,
or obedience clubs? Yes [ ], No [ ]. If yes, list names of
clubs, dates of membership, and any officies held.
10. Have you ever been or are you now suspended by the AKC? Yes [ ],
No [ ]. If yes, give dates and complete details.
I/We hereby apply for membership in the Norwich and Norfolk Terrier
Club. If accepted, I/We agree to abide by its Constitution
and By-Laws, Rules and Regulations, and the rules of the
American Kennel Club. I/We also agree to abide by the
NNTC Members Code of Ethics and understand that failure
to do so may result in disciplinary action by the Club.
Signature:
Date:
Signature:
Date:
Return the application, the two sponsors questionnaires and the non-returnable
$15.00 fee to:
Carol Jordan
604 Old Fritztown Road
Reading, PA 19607-1016