Great Dane Club of Mid-Florida

Membership Application

PLEASE PRINT:

Name: ____________________________________________________

Address: __________________________________________________

Phone Number: _________________E-mail Address: ________________

Occupation: ________________________________________________

Number of Dogs owned: _______ Number of Dogs co-owned: _______

____Pet ____Breeder ____Conformation ____Obedience ____Agility

____Tracking ____Rescue ____Other: ___________________________

When did you get your first Great Dane? __________________________

What color Great Danes do you own? ____Black ____Blue ____Brindle

____Fawn ____Harlequin ____Mantle ____Other Color ______________

Kennel Name: ______________________________________________

How many AKC registered litters have you bred? _____

As a member, you must rescue dogs that are bred by you, should the dog need to be rescued.

Have/Would you ever wholesale a puppy? ____

Other Dog Club Affiliations: ___________________________________

Would you be interested in participating in any of the following: ___Web

Site ___ Membership ___Officer___ Show Chair ___Committee Chair

I certify that all the questions are answered truthfully to the best of my

knowledge. If my application is accepted, I agree to abide by the Constitution & Bylaws of the Great Dane Club of Mid-Florida and Great Dane Club of America as well as the rules of the American Kennel Club. I hereby certify that I am in good standing with the American Kennel Club.

Signature: ____________________________________ Date: _______

Both Sponsors cannot be of the same household. Neither Sponsor can be related to applicant. The membership committee will contact your sponsor. Please visit our web site for club Constitution & Bylaws www.greatdaneclubofmidflorida.org

Sponsor, print name: _________________________________________

How long have you known the applicant? ___________________________

Why do you recommend him/her for membership? ___________________

_________________________________________________________

Sponsor, print name: _________________________________________

How long have you known the applicant____________________________

Why do you recommend him/her for membership? ___________________

_________________________________________________________

Make check payable to: Great Dane Club of Mid Florida (GDCMF)

Dues are $20 per person/per year. Check # _______

Date of Acceptance: ____________ Date of Denial: _______________