GREAT DANE CLUB OF WESTERN NEW YORK

GREAT DANE CLUB OF WESTERN NEW YORK, INC.

(Application for Membership)

(two pages)

Name:______________________________________ Email Address: ___________________________

Address: ______________________________________________________________________________

City:____________________________________ State: __________________ Zip Code: _____________

Home Phone:_____________________________ Business Phone: _______________________________

--------------------------------------------------------------------------------------------------------------------------------

Description of Great Danes Owned / Co-Owned** At Present:

AKC Registration Number AKC Registered Name Sex / Color

_____________________________________________________________________________________

** if Co-Owned, List Name and Address of Co-Owner(s):

_____________________________________________________________________________________

Do you have breeding contracts on any dogs you co-own? Yes __________ No __________

How many AKC registered litters have you bred? ____________

Do you provide facilities for your dogs on your property? Yes __________ No __________

If so, what facilities do you provide? _____________________________________________________________________________________

_____________________________________________________________________________________

If not, where are they kept and by whom? _____________________________________________________________________________________

_____________________________________________________________________________________

Have you every wholesaled a puppy or a litter of puppies? Yes __________ No __________

Would you ever wholesale a puppy or a litter of puppies? Yes __________ No __________

--------------------------------------------------------------------------------------------------------------------------------

Do you know-understand-and agree to abide by The Great Dane Club of Western New York’s constitution, by-laws and code of ethics? Yes _________ No __________

Applicants Signature(s) ______________________________ _________________________________

Sponsors: (2 required): _____________________________ _________________________________

--------------------------------------------------------------------------------------------------------------------------------

Membership: Approved: _________________ By: _______________________________

Not Approved: _________________ Date: _______________________________

**Annual Membership Fee***

$ _____________________________ Per Person

*Membership approved after October 1^st - dues will apply to the next year.

Great Dane Club of Western New York, Inc.

Application Interview

1. What is your primary interest in the Great Dane fancy?

Pet __________ Showing __________ Breeding __________ Obedience __________

2. Have you owned any other Great Danes? Yes __________ No __________

If yes, what became of the dog(s)? _________________________________________________________

_____________________________________________________________________________________

3. Why are you interesting in becoming a member of this club? ________________________________

_____________________________________________________________________________________

4. Are you willing to work on committees for this club? Yes __________ No ___________

5. Have you belonged to any other dog clubs? Yes __________ No __________

If yes, what club(s)? ________________________________________________________________

Are you still a member? Yes __________ No __________

If no, why did you leave the club? _____________________________________________________

Did you hold any office or head any committee? Yes __________ No __________

If yes, in what office(s) did you serve/what committee did you head? _________________________

_________________________________________________________________________________

Applicant(s) Name: _____________________________________________________________________

Date of Interview: _____________________________________

Sponsor’s Signature: ___________________________________________________________________

Dear

You have sponsored _____________________________________________________________

Who resides at _________________________________________________________________________

For membership in THE GREAT DANE CLUB OF WESTERN NEW YORK, INC.

In order for the Membership Committee to process the application for membership I would appreciate if you would answer the following questions and return this form to me at the address below.

1. Do you know the applicant personally? Yes __________ No __________

If yes, length of time you have known the applicant. ________________

2. Is the applicant interested in buying and selling dogs as a business, either as a sideline or as a principal occupation? Yes __________ No __________

3. Is the applicant interested in the welfare and advancement of the breed? Yes ______ No ______

4. Please give any other information concerning the applicant which you feel might help the Committee recommend approval of the application (use reverse side if necessary).

_____________________________________________________________________________________

--------------------------------------------------------------------------------------------------------------------------------

5. Have you been a member of THE GREAT DANE CLUB OF WESTERN NEW YORK, INC. for at least two (2) years? Yes __________ No __________

Signed: ____________________________________________________________ Date: _____________

Address: ______________________________________________________________________________

_____________________________________________________________________________________

--------------------------------------------------------------------------------------------------------------------------------

CONFIDENTIAL COMMENTS WILL BE KEPT IN STRICT CONFIDENCE