Application for Membership – Gem City Dog Obedience Club

Name:*

First

Last

Address:*

Street Address City State / Province / Region Postal / Zip Code

Home Phone:*

Area Code

-

Phone Number

Work Phone:

Area Code

-

Phone Number

Cell Phone:

Area Code

-

Phone Number

E-mail:*

Dog Breeds:

Classes you have completed at Gem City (two are required):

First Class:*

Date Of First Class:*

Second Class:*

Date of Second Class:*

I agree to abide by the Constitution and By Laws and Standing rules of Gem City Dog Obedience Club, Inc.

Digitial Signature (Type your full name):

If Gem City volunteer hours have already been completed, please indicated the function, date and hours completed.

Volunteer Hours Information:

Once you have been voted in, you may add anyone in your household that is over 18 for $10 and anyone between the ages of 8-17 as a junior member for $1.