THE SHOW-ME BASENJI CLUB
APPLICATION FOR MEMBERSHIP
NAME OF APPLICANT ________________________________________________
NAME OF CO-APPLICANT_____________________________________________
ADDRESS__________________________CITY_______________STATE_______
TELEPHONE #______________________________
E-MAIL ___________________________________ Web Address_____________
OCCUPATION(s)____________________________________________________
DO YOU OWN A BASENJI? ___________________ HOW MANY? _______
DO YOU PLAN TO BREED YOUR BASENJI?______________________________
Do You Plan to Show in Conformation or Compete in Field events? ___________
HAVE YOU EVER REGISTERED A LITTER WITH AKC? _____HOW MANY?_____
Constitution & Bylaws may be viewed at www.showmebasenjiclub.com
******************************************************************
The undersigned hereby applied for membership in the SHOW-ME BASENJI
CLUB, INC. By signing I/we acknowledge having read the Constitution and by-laws
and if this application is approved, I/we agree to be governed by the by-laws of the
club, to further the objectives of the constitution of the SHOW-ME BASENJI CLUB.
DATE: __________SIGNATURE(S) ___________________________________
___________________________________
SPONSOR: ________________________________
SPONSOR: ________________________________
Send this application along with the appropriate dues of $7.50 single or $10.00 family to: Show Me Basenji Club
Secretary Jan Kahl