RUSSIAN TSVETNAYA BOLONKA CLUB

Membership Application

Breeders, exhibitors, and pet owners are invited to become members of the RUSSIAN TSVETNAYA BOLONKA CLUB OF AMERICA. Currently the RTBCA is AKCFSS and all Bolonka registrations are to go through them http:/tsvetnayabolonkaclub.homestead.com

The four categories of membership are regular, household, associate and foreign. To become a regular or household member, you must meet the following requirements:

1) be at least 18 years old and be in good standing with the AKC and all rare breed show organizations. 2) Subscribe to the purposes of the Russian Tsvetnaya Bolonka Club of America.

3) Own or Co-own at least one Tsvetnaya Bolonka which is either registered in Russia or with the American Kennel Club (AKC)

A)Regular Membership: $25.00. Regular members are entitled to vote and hold office.

You must be at least 18 years old and own or co‐own a Tsvetnaya Bolonka that is

registered with AKCFSS or an acceptable foreign registry.

B)Family Membership: $30.00. Family membership is open to two regular members

living at the same address. Each member must be at least 18 years old and own or

co‐own a Tsvetnaya Bolonka that is registered with RTBCA or an acceptable foreign registry. Family membership is the same as Regular membership but has two votes. x

C)Associate Membership: $15.00. Associate members cannot vote or hold office.

Associate membership is open to any who choose not to become a regular member or do not own a Tsvetnaya Bolonka.

Junior Membership: $15.00. Open to persons ten through seventeen years of age who

have demonstrated an interest in the Tsvetnaya Bolonka and the purposes of the Club.

Junior members must live in the United States, cannot vote or hold office, and do not

count when determining a quorum. On reaching the age of eighteen (18), a junior member may apply to the club following the application and election procedures required for new members. On reaching the age of eighteen, a Junior member may apply to the Club, following the application and election procedures required for new members, to

convert his or her Junior membership to a Regular or Family membership.

D)Foreign Membership: $15.00. Open to any person who lives outside the United

States. Foreign members cannot vote or hold office, and do not count in determining a

quorum. The membership of any Regular, Family or Junior member who no longer reside in the United States shall automatically convert to a Foreign membership. If the member

re‐establishes residence in the United States, they may change their membership back to a Regular, Family or Associate membership.

Any member wishing to remain on the breeder referral page will be required to pay an

additional $15 annually due January first of each year.

Dues will not exceed $50 for all members (a) living at the same domicile and (b) who bear an immediate familial relationship to each other for any fiscal year (January 1 - December 30).

Send the completed application with the appropriate dues to:

Robbie Sternlict

RTBCA

2712 Bennington Rd., Fayetteville, NC 28303

Email:

Name__________________________________________________________________________

Address__________________________________________________________________

City__________________________State____________Zip_____________________________

Phone (____)_____-________ E-mail____________________________

Occupation___________________

Please place a X in front of which ever category applies:

____Pet Owner

____Pet Owner with Neutered Pets

____Breeder

_____Active Show Home

See back of application to elect how you want to receive NATBC mail.

Type of membership: Regular ______ Household ______ Associate ______ Jr.______

Registered Name of Tsvetnaya Bolonka you own or co-own

____________________________________________________________

Registration Number of Tsvetnaya Bolonka you own or co-own

________________________________________________

List others on the back of this application.

Do you plan to show any of your Tsvetnaya Bolonka? _________ Do you plan to breed your Tsvetnaya Bolonka? _________

What other breeds do you own? ____________________________ Have you bred or shown before? _____

I am interested in: Obedience___ Breeding___ Exhibiting___ Agility___ Other___(describe on back.)

Other dog clubs of which you are or have been a member and the membership length:

______________________________________________________________________ How long? ______

______________________________________________________________________

How long? ______

Do you have skills or experience you can share with the club?

___________________________________

I am in good standing with all rare breed show organizations and registries as well as the AKC. I agree to abide by the NATBC Constitution and By-laws.

MEMBERSHIP DUES MUST ACCOMPANY APPLICATION (Note: Since all are charter members as we work our way to AKC breed recognition, dues are not required for the rest of 2010 thru 2012)

Please enclose a check or money order in US funds payable to NATBC

Mail Election

As a NATBC member, I prefer to receive my Club mail via: (check only one):

______ E-mail. (Please write preferred e-mail address on front of this application in space provided)

I understand and agree to hold NATBC harmless for using my preferred e-mail address, recognizing Internet failures do occur and that it is not a secure mode of transmission.

______ U.S. Postal Service. (Please provide preferred mailing address below if different from your address on front of this application.)

List other TSVETNAYA BOLONKAS you own or co-own below

Registered Name of Tsvetnaya Bolonkas Registration Number

Use back of paper if you need to

_____________________________________________________________________

_______________________________________________________________________

________________________________________________ _______________________

________________________________________________________________________

Other Interests

_____________________________________________________________________________________

For NATBC Secretary’s use only:

Date first membership dues received ________________________________________________________

(waived for those joining in 2010 and 2011)

NATBC Membership Form

Revised 03 February 2010