Application For Reinstatement
Application to be filled out by candidate(s) applying for reinstatement into membership in the Charleston Kennel Club Inc. Please include dues with application. Dues are $15.00 for single membership and $20.00 for families.
Address:
________________________________________________________________________________
Business: _______________________________________________________________________________
Home Phone: _______________________ Can you be called at work? If so, number: ________________
Kennel Name:
_______________________
Breed(s)
____________________________________________
1. Please indicate what years you actually belonged to the
2. List other dog clubs of which you are a member:
___________________________________________________________________________________
___________________________________________________________________________________
3. In the space below (use reverse if
needed), please outline your reason(s) for allowing your previous membership in
the Charleston Kennel Club Inc., to lapse.
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
4. Do you intend to take an active part in club
activities? (_)no (_)yes
If yes, in what manner do
you plan to contribute?
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
5. What are your present interests? (Please check all that apply)
( ) Breeding ( ) Conformation ( )
Obedience ( ) Field Trials ( ) Tracking
( ) Therapy ( ) Rescue ( ) Agility ( ) Pet Owner ( ) Other ____________
6. Have your privileges as a judge, exhibitor or breeder ever been revoked
or suspended y the AKC?
( ) No (
) Yes If
yes, please explain on back of form.
7. Have you read the Constitution and By-Laws of this Club?(Available on
the Charleston Kennel Club Website.)
( ) No (
) Yes
8. Do you agree to abide by and uphold the Constitution and By-Laws of
this Club? ( ) No ( ) Yes
I/We, the undersigned, hereby apply for membership reinstatement in the Charleston Kennel Club, Incorporated. I/We agree to abide by the Constitution and By-Laws of the CKC and the American Kennel Club. I/We have read the questions set forth on this application and have answered the same truthfully and completely.
Date:
______________________________
Signature(s):
_______________________________________________________________________________
Action of the Board of Directors: _________________________________________ Date: ________________