Date received __________                                                                 Approved_____Rejected_____
First reading ___________
Second reading _________
Dallas Shetland Sheepdog Club, Inc.
Membership Application

Name________________________________________Phone H____________W___________

Address______________________________________City________________St___Zip_____

Occupation__________________________________EMail____________________________

Kennel Name_________________________________________________________________

Type of Shetland Sheepdog fancier: (Please check as many as applicable)
Breeder___Hobby___Pet___Show___Obedience___Agility___Herding___

Number of Dogs_____ Bitches_____

(On the reverse side, please give registered names(s), AKC number(s), birth date(s), and sire and dam of each dog.)
How many years have you been a Shetland Sheepdog fancier?_________
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1) Have you ever been suspended by the American Kennel Club?____
If yes, give details on reverse side.
2) Are you now, or ever have been, a member of any Breed or Kennel Club?____
If yes, name them on the reverse side.
3) Have you ever been suspended from any Breed or Kennel Club?____
If yes, give details on reverse side.
4) Have you ever been cited by the S.P.C.A. or Animal Control?____
If yes, give details on reverse side.
Recommended and endorsed by the following DSSC members:
1. ___________________________________________________________
2. ___________________________________________________________

IMPORTANT - A CHECK AND SIGNED CODE OF ETHICS MUST ACCOMPANY THIS APPLICATION