APPLICATION FOR MEMBERSHIP ONLINE

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Applicant's Details:

Title (Mr/Mrs/Miss/Ms):

First Name:

Surname:

Street Address:

Suburb:

State:

Postcode:

Email:

Confirm Email:

Phone:

Mobile:

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Dog's Details:

Name Of Dog:

Breed Of Dog:

Age Of Dog:

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Second Dog's Details (if applicable):

Name Of Dog:

Breed Of Dog:

Age Of Dog:

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Third Dog's Details (if applicable):

Name Of Dog:

Breed Of Dog:

Age Of Dog:

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MEMBERSHIP OPTIONS:

Standard membership rates apply. An initial joining fee is applied to the membership as a one off payment, annual membership renewal therafter will exclude joining fee.

New Membership or Renewal:

New Member (a joining fee of $30 applies)
New Member with PAA dog (joining fee waived). Please enter PAA dog reference number:
Renewal Membership

Please tell us what type of membership you are purchasing:

Single (one adult or one child under 16)
Family (2 adults and/or 2 children under 16)

Concession Holder / Full Time Students:
If you hold a concession card or are a student, please enter concession or student number

VCA Members:
If you are a VCA member, please enter your VCA number. (A discount applies to VCA members)

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How Did You Find Us?:

Flyer Newspaper Friend Internet Other

Other:

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I agree to abide by the Constitution, Rules and Regulations of The Hastings & District Obedience Dog Club Inc. The club will not be liable for personal injury, property loss or damage on the training ground. I understand that before attending classes I will be required to provide proof of current Vaccination Certificate(s).
I Agree:

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