Membership Application: Please Print out and mail or bring to the next club meeting.

Download the form here






Pacific Northwest Miniature Pinscher Club, Inc.

Membership Application

Please read and answer all questions, (type or print clearly)

 

 

NAME: 

 

 

ADDRESS:

 

 

 

CITY:                                                                     

 

STATE 

 

ZIP

 

 

PHONE:                                                                                  

 

 

BUSINESS:

 

 

KENNEL NAME:

 

 

OCCUPATION:

 

 

EMAIL

 

 

Are you a member in good standing with the American Kennel Club?

 

 

 

 

YES     NO

 

 

Are you a member in good standing with the Miniature Pinscher Club of America?

 

YES     NO

 

 

Have you ever been suspended by AKC or any of the above Clubs?

 

YES     NO

 

(If yes, please attach a separate sheet with an explanation)

 

 

How long and in what capacity have you been involved in purebred dogs?

 

 

 

What are your areas of interest?  

Pet , Boarding , Conformation , Rally, Obedience, Agility, Other (i.e. therapy dogs etc.)

 

What other breed(s) do you own now or have owned in the past?

 

 

 

How many miniature pinschers do you own at this time?

 

Please provide the name and address of the person from whom you obtained your last miniature pinscher (other than your own breeding):

 

 

How many litters (all breeds) have you bred in the last five years?

 

 

How many litters of miniature pinschers have you breed in the last five years?

 

 

 

 

 

 

 

 

Have you earned AKC Championships or Obedience titles on the dogs owned by you?

YES     NO

 

 

Are you or any member of your immediate family involved in a commercial kennel, pet shop, or grooming shop that buys or sells dogs?

 

YES     NO

 

(If yes, please attach a separate sheet with an explanation)

 

 

Do you or any member of your immediate family, buy or sell litters or individual dogs for resale?

 

 

YES     NO

 

(If yes, please attach a separate sheet with an explanation)

 

Why do you want to become a member of the Pacific Northwest Miniature Pinscher Club?

(Attach a separate sheet if necessary)

 

 

 

Membership dues are $10.00 per year, for a regular membership which includes voting privileges,

ability to hold an office and serve on committees.

 

Associate Membership fees are $5.00 per year and do not include voting privileges, nor may they

hold an office or chair a committee.  Associate members are encouraged to participate on committees.

 

Foreign Members are only eligible for associate membership.

 

 

 

Applying for:

Regular membership

Associate membership

Residence is:

Inside of club territory

*Outside of club territory

 

 

I, the undersigned apply for membership in the Pacific Northwest Miniature Pinscher Club. regardless of membership type I will comply with the Code of Ethics of the MPCA.

 

*Note: if outside of club territory and applying for regular membership, the (prerequisite) requirements

 are to attend three meetings and volunteer to work on one committee in the year you are applying for

membership. Once the requirements are fulfilled send meeting dates and committee info to club secretary.

 

With your application include a signed copy of the MPCA Code of Ethics.

 

 

Applicant Signature:

 

 

Date:

 

 

Sponsor Signature:

 

 

Date:

 

 

Sponsor Signature:

 

 

Date:


11-24-17



 

 

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