Grand Canyon State Rottweiler Club Membership Application
Please fill out application completely.
Attach as many additional sheets of paper as necessary to completely respond to all questions. The GCSRC Board of Directors reserves the right to request additional information and/or ask for clarification
of responses.
Name(s):__________________________________________________________
Address:___________________________________________________________
Home Phone:_______________________________________________________
E-Mail Address:____________________________________________________
Kennel Name
(if any):________________________________________________
Occupation(s):______________________________________________________
1. Do you currently own one or more Rottweilers? Yes_____ No_____
How many?_____ How long have you owned Rottweilers?___________
2. List the following information for ALL Rottweilers you currently own.
Use separate paper if necessary.
__________________________________________________________________
Registered Name:_________________________________________________________
AKC Number (if
any):_____________________Date of Birth:___________Sex:___
Breeder:___________________________________________________________
OFA, CERF #s
(if any):______________________________________________________________
Other Certifications?_________________________________________________
Sire:_____________________________Dam:_____________________________
Co-owner (if
any):___________________________________________________
Dog's Titles
(if any):_________________________________________________
__________________________________________________________________
3. Have you ever exhibited your Rottweiler(s) in Conformation, Obedience, Tracking, Herding, Agility, Schutzhund,
Other? Yes_____ No_____
4. Is your Rottweiler trained in a special activity such as Therapy, Search and Rescue, Attack/Guard Work,
etc? Yes_____ No_____
In what areas?
__________________________________________________________________
5. Are you a member of any other dog clubs? Yes_____ No_____
If yes list
club(s) and offices held (if any):________________________________
6. Are you a licensed judge? Professional handler? Professional trainer? Are you affiliated with or act as an
agent or broker for any type of dog-related business?
Yes_____ No_____ If yes, please give specific
details on a separate sheet of paper.
I/we hereby
apply to the Grand Canyon State Rottweiler Club for membership (check one):
_____ Single
Membership ($15 per year): one (1) person, 18 years of older, who currently owns
a Rottweiler, and is in good standing with the American Kennel Club. Individual
is entitled to one (1) vote after attending two (2) GCSRC meetings.
_____ Family
Membership ($20.00 per year for first family member, $10.00 for each additional member):
more than one member of a given family residing in the same household, 18 years or older, who currently own a Rottweiler,
and are in good standing with the American Kennel Club. Each member entitled
to one vote after attending two GCSRC meetings.
_____ Associate
Membership ($10.00 per year): One (1) person, 18 years or older, who currently
does not own a Rottweiler, is in good standing with the American kennel Club. Individual
is not entitled to hold office or vote. May change status to Single Membership
when (s)he becomes an owner of a Rottweiler and proof of ownership is supplied.
I/we have completed
this application in a true and accurate manner. I/we declare that I am/we are
18 years of age or older, in good standing with the American Kennel Club, and agree to read and abide by the Constitution,
Bylaws, and Code of Ethics of the Grand Canyon State Rottweiler Club.
________________________________________________________________________
Signature of
Applicant
Date
________________________________________________________________________
Signature of
Applicant
Date
* As stated
in Section 3 of the Grand Canyon State Rottweiler Club Bylaws, each applicant must carry the endorsement of two current members
in good standing. In order to become a voting member, each applicant must attend
two Grand Canyon State Rottweiler Club meetings. This application will be submitted
to the Secretary, and will be voted on by the Board of Directors at the following Board meeting. The application must pass with a 2/3 affirmative vote by the Board.
The application will then be presented at the following club meeting to be voted upon by secret ballot, and must pass
with a 2/3 majority vote of those members present at that meeting. Club dues
are due upon election into the club.
__________________________________________________________________
Endorsement
of Member #1
Date
__________________________________________________________________
Endorsement
of Member #2
Date
