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Dachshund Fanciers of Central Virginia

Application for Membership

The objectives of the club are to:


APPLICATION FOR MEMBERSHIP INFORMATION

I hereby make application for membership in the Dachshund Fanciers of Central Virginia. I agree to abide by the Constitution and By-laws of the Club, and to help achieve its objectives in the spirit of friendliness and sportsmanship set forth.

My check/cash/money order is enclosed for ________
(Fee is $15.00 for single membership or $25.00 for family membership)

Name of Applicant(s) (Please Print):________________________________________________

        Address: ___________________________________________________________________

        Phone (home): (___)_________Office: (___)_____________

    Email Address: ______________________

    How many years in Dachshunds?______________   

    In what capacity? ________________________________

    How many Dachshunds do you own?_________   Co-own?________    

    How many live with you?___________

List all Dachshunds currently owned or co-owned by you. (use extra page if needed)
Name            AKC#            Sex        DOB            Co-Owner
     
___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________


Name and address of person from whom you obtained your last dachshund:

_______________________________________________________________

What other breed(s) do you own or have you owned in the past?

_______________________________________________________________

How many litters have you registered in the past 3 years? (all breeds)________
Please list (attach an additional sheet if necessary):

Breed            AKC Litter Registration #                Date Whelped

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

What are your areas of interest (please check all that apply):     

Conformation______ Obedience______Field Trials____Earthdog Tests____
   
Tracking ____ Agility ____ Rescue ____ Breeding ____

List all dog club affiliations and any past and present positions held:

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

    Are you in good standing with (please circle):

        AKC:   Yes   No

        Dachshund Club of America:   Yes   No   Not a Member

        National Miniature Dachshund Club:   Yes   No    Not a Member


Do you exhibit or participate at AKC Events? _______

How many years have you been participating? _______

How many events do you attend in a 12 month period?____________________

Why do you want to join DFCV and what are your membership expectations? 

____________________________________________________________________________________

____________________________________________________________________________________


What contributions do you feel you can make to the club?   

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________
   

Sponsors Signatures: (Please provide two) (Sponsors must be members in good standing with DFCVA)

        1.______________________________________________

        2.______________________________________________


I wish to become a member of The Dachshund Fanciers of Central Virginia. I agree to abide by the Bylaws, Code of Ethics, rules of DFCV and rules of the American Kennel Club.

 Signature of Applicant:______________________ Date:_________________

       
        Please make checks/money orders payable to:
        Dachshund Fanciers of Central Virginia
       
        Mail to:
        Kitty Johnson
        1200 Peachtree Blvd
        Richmond, VA 23226
        (Phone: 804/285-2766 for questions)


 



For office use:

Notified member ________(Date)

Secretary initials ________






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