Membership Application

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1 Membership Application I hereby make application for (choose one) Regular ($25) Family ($30) Associate ($20) Junior ($10) Foreign ($20) membership in the and enclose the annual dues for the year of. I agree to abide by the Constitution and By-Laws of the (and the rules of the American Kennel Club). Applicant Name(s): (1) Occupation (2) Occupation Kennel Name: cell (1) work (1) cell (2) work (2) Website:

2 Membership Application (page 2) Why do you wish to join the ANA? (attach an additional page, if necessary) Number of rrbottenspets owned/co-owned: Other dogs: List all dog titles and accomplishments (attach an additional page, if necessary): List all memberships in other Breed or All Breed Clubs, duties/offices held, and dates of membership (attach additional page, if necessary): What skills can you contribute to the ANA? (attach additional page, if necessary) Which of the following activities interest you? Conformation Obedience Rally Obedience Lure Coursing Agility Tracking Other: Are you willing to screen your dogs for hereditary genetic problems? Do you accept responsibility for any dog of your breeding that comes into a rescue situation? Would you be able to foster a rescue rrbottenspets not of your breeding? : Temporarily, Permanently Do you sell or consign or have you ever sold or consigned dogs to retail or wholesale outlets or other persons supplying them?

3 Membership Application (page 3) My signature below is a request for membership and an acknowledgement of and agreement to the following: I grant permission to members of the ANA to review my application. I certify that the information given in this application is factual and complete. I understand that discovery of false or misleading information in my application may result in rejection of my application, or, if discovered after my membership is accepted, may result in expulsion from the membership. I give the ANA my permission to contact the sponsors listed in this application and hold said sponsors and the club harmless if my application for membership is rejected. I have read the ANA Code of Ethics and agree to abide by its guidelines. Signature (1): Date: Signature (2): Date: Sponsorship by two voting members of the is required for membership. If you would like to receive all official notifications (meetings, dues reminders, minutes, newsletter, and the like) of the ANA via , please sign the waiver below. This authorization can be revoked at any time with written notification to the secretary for the ANA. Also, by signing this authorization, the ANA will not be held responsible should the notification be received late or not received by the member or board member due to circumstances beyond the club s control. I would like to receive all ANA notifications via Signature (1): Date: Signature (2): Date: I would like to receive all ANA notifications via USPS mail: Signature (1): Date: Signature (2): Date:

4 Membership Application (page 4) Sponsor 1: Name (Printed) Signature: Date: cell work Sponsor 2: Name (Printed) Signature: Date: cell work Please make check payable to:. Mail application with dues payment to: Sue Vareberg ANA Secretary/Treasurer 4031 Country Way The Dalles, Oregon 97058

5 Members of ANA pledge to abide by the Code of Ethics: The purpose of this Code is to set forth principles of practice that the ANA Board would like to have members adhere to as they strive to preserve the quality of the breed. The Code represents the minimum in ethical practices. To this end, the member agrees: 1. To abide by and uphold the principles of the Constitution and By-Laws of the American rrbottenspets Association. 2. To understand and abide by all Rules and Regulations of the American Kennel Club and its Code of Sportsmanship. 3. To accept and breed only to the Standard of the breed as set forth by the ANA and approved by the American Kennel Club, striving always to maintain the highest quality for the breed as outlined by the Standard. 4. To require that any agent, employee or other person acting on behalf of the member comply with all principles outlined in this Code of Ethics and Guidelines. 5. To provide the best possible environment for the physical and emotional well-being of the dogs including fully complying with local laws governing health inoculations, curbing of animals, and restraint and control of their actions on and off their home premises. 6. To put the welfare of each dog above personal gain, profit and/or personal convenience, remembering that each dog (purchased, bred or sold) is a lifetime responsibility. 7. To make every effort to assist the novice and educate the public regarding the rrbottenspets and provide accurate information as to their general upkeep, the maintenance of their well being, grooming and training needs. 8. To strive always to behave in a sportsmanlike manner and refrain from misleading and false advertising, maligning or giving false statements regarding dogs, breeding practices and ANA members. 9. To support ethical trades practices and sell only to responsible persons. To avoid at all cost the wholesaling of litters of rrbottenspets puppies, or the sale of breeding stock or individuals to pet shops or other commercial sources of distribution and never to provide dogs for the purpose of raffle, lottery, or auction. thing in this Code of Ethics should be construed to be in violation of the Rules and Regulations of the American Kennel Club or the Constitution and By-Laws of the American rrbottenspets Association.

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