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PARSON RUSSELL TERRIER ASSOCIATION OF AMERICA, INC. |
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Foreign Membership is open to persons 18 years of age and older who wish to receive the newsletter.
Foreign members are ineligible to vote or hold office and said members shall not count in determination of a quorum.
Fee: $30 (US Funds) Make check payable to PRTAA, and mail completed application to:
Peggy Crane, PRTAA Secretary
4129 Keefer Road, Chico, CA 95973 USA
NAME__________________________________________________________________________________________
ADDRESS_______________________________________________________________________________________
_________________________________________________________________POSTAL CODE________________
PHONE_(______)______________________________________ EMAIL___________________________________
OCCUPATION___________________________________________________________________________________
KENNEL NAME _______________________________________________________________________________
YOUR PRIMARY INTEREST(S) IN DOGS: COMPANION__________SHOW___________
PERFORMANCE (specify) _______________________________________________________________________
OTHER (specify) ____________________________________________________________________________
BREEDS PRESENTLY OWNED: Parson Russell Terrier ________HOW MANY_____________________________
Other Breeds: (Specify Breed(s) and How Many)___________________________________________________
HAVE YOU BRED ANY PARSON RUSSELL LITTERS?_______HOW MANY_____________________________
OTHER BREED(s)? (Specify Breed and How Many)_____________________________________________
________________________________________________________________________________________________
DO YOU BELONG TO OR HAVE YOU BELONGED TO ANY OTHER KENNEL OR SPECIALTY CLUBS?___________
IF SO, LIST NAMES OF CLUBS, OFFICES & DATES HELD, AND REASON FOR LEAVING IF ________________________________________________________________________________________________ ________________________________________________________________________________________________ HAVE YOU EVER BEEN SUSENDED FROM AKC/PRTAA/JRTAA PRIVILEGES?______ IF SO, LIST DATE AND REASON FOR SUSPENSION_______________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ARE YOU PRESENTLY IN GOOD STANDING WITH THE AKC?______IF NOT, WHY? ________________________________________________________________________________________________ ________________________________________________________________________________________________
NO LONGER
A MEMBER:
________________________________________________________________________________________________
Signature___________________________________________Date___________________
PRTAA/SLT/11-04 (Internet version 1) END OF FORM
