Microsoft Word - MCOF-MA -...
Transcript of Microsoft Word - MCOF-MA -...
MASTIFFF CLUB OF FLORIDA MEMBERSHIP APPLICATION PO BOX 220026 Glenwood, FL. 32722
HOSEHOLD MEMBERSHIP ( ) SINGLE MEMBERSHIP ( ) JUNIOR MEMERBSHIP ( ) CHARTER ( )
LIFETIME ( )
SECTION I APPLICANT:
LAST NAME ___________________________FIRST NAME_______________________________
PHONE: _________________________ E-MAIL:___________________________________
MAILING ADDRESS: ____________________________________
CITY: _____________________________ STATE: ___________ ZIP CODE: __________________
DOB: __________________________
OCCUPATION: ___________________________________________________________________
SECTION II FILL IN THIS SECTION FOR HOUSEHOLD MEMBERSHIP ONLY SPOUSE_______________________________OTHER____________________________________
PHONE: __________________________E-MAIL: _______________________________________
DOB: _________________________________
OCUPPATION: ____________________________________________________________________ CHILDREN:
NAME: ________________________________DOB: ______________________________________
NAME: ________________________________DOB: ______________________________________
NAME: ________________________________DOB: ______________________________________
NAME: ________________________________DOB: ______________________________________
NAME: ________________________________DOB: ______________________________________
SECTION III MASTIFFS IN HOUSEHOLD: _________________________________________________________
LIST OTHER BREEDS IN HOUSEHOLD: _______________________________________________
SECTION IV PLEASE INDICATE YOUR AREA OF INTEREST: OBEDIENCE ( ) CONFORMATION ( ) THERAPY ( ) BREEDER ( )
ARE YOU AN MCOA Member? Yes ( ) No ( ) PENDING ( )
SECTION V MCOF ENCOURAGES ALL MEMBERS TO BE ACTIVE AND ATTEND QUARTERLY MEETINGS WHEN POSSIBLE. PLEASE CHECK ALL AREAS YOU MAY WANT TO LEARN MORE ABOUT BEING A PART OF: MEMBERSHIP ( ) TRAINING ( ) RESCUE ( ) EVENTS ( ) MARKETING ( ) WEBMASTER ( ) V.A. PROGRAM ( ) AT RISK KIDS PROGRAM ( ) EDUCATION ( ) FUND RAISING ( ) NEWSLETTER ( ) LEGISLATION ( ) ETHICS ( )
LIST OTHER: _______________________________________________________________________
I HAVE READ AND UNDERSTAND THE ELIGIBILTY REQUIREMENTS OF THE MASTIFF CLUB OF FLORIDA AND AGREE TO THE WAIVER & RISK AGREEMENTAND THE CODE OF ETHICS AND AGREE TO ABIDE BY THEM AS CONDITIONS OF MEMBERSHIP. SIGNATURE OF APPLICANT(S) ________________________________________________
DATE ________________________________________________________________________