This form should be returned to the applicant.
Sponsor:
Sponsor Address:
Sponsor Phone:
Sponsor Fax:
Sponsor E-mail:
Applicant:
Applicant Address:
Applicant Phone:
Applicant Fax:
Applicant E-mail:
1. How many years have you known the applicant?
2. How many Norwich/Norfolk (please circle) does the applicant own or co-own?
3. Does the applicant show and/or breed these dogs? Yes [ ] No [ ]
4. Does the applicant own other breeds of dogs? Yes [ ] No [ ]
If yes, list breed(s) and the number of each.
5. Describe the applicant's involvement with Norwich/Norfolk (exhibiting in
conformation, agility, obedience, tracking, pet therapy work, pet
companion, etc.)
6. Does the applicant intend to breed these dogs? Yes [ ] No [ ]
7. Does the applicant's dog provide stud service? Yes [ ] No [ ]
8. Please check any particular committee(s) in which you think the applicant might best serve the Club:
Education [ ], Health-Genetics [ ], Newsletter [ ], Obedience [ ], Show Tropies [ ], Ways and Means [ ], Working Terriers [ ]
This form should be returned to the applicant.
Sponsor's Signature:
Date: