APPLICATION FOR MEMBERSHIP
I/We wish to apply for membership into the
Old English Sheepdog Club of
To be eligible for household membership both applicants must reside at the same address.
Please print or type:
NAME:_________________________________________ 1st applicant
NAME:_________________________________________ 2nd applicant
Phone: _____________________________e-mail: _______________________________
_______ Conformation _________ Herding _________Obedience _________Agility
________ Pet (includes adoption of rescue as pet) _______ Rescue work _________Juniors
DUES: DONATION $ ________________
Individual $ 12.00 ______
Household $ 18.00 ______
Junior (10-18 yr.) $ 10.00 Junior DOB: _____________
I agree to comply with the By-Laws and Code of Ethics of the Old English Sheepdog Club of Central Florida .
I have enclosed a payment in the amount of $ _____________US funds.
Signature: ____________________________________ (1st Applicant)
____________________________________ (2nd Applicant)
Date : _________________
This form and a signed Code of Ethics should be sent to:
English Sheepdog Club of
Membership Chairman: Linda Liljequist
1517 Schalamar Creek Dr.
Lakeland, Florida 33801