/ Golden Triangle Obedience Training Club, Inc.
APPLICATION FOR FULL MEMBERSHIP

I (We) hereby make application for membership in the Golden Triangle Obedience Training Club, Inc. (“GTOTC”). It is understood that dues are to be submitted with this application, if applicable. Term of membership for one (1) year begins May 1 and ends April 30th. This application is submitted with the understanding that, if approved by the membership, I (we) agree to abide by the Constitution and By-Laws of the GTOTC and the rules of the American Kennel Club.

Requirements:

  1. After serving and meeting all the 6-month provisional membership requirements, complete this full membership application, sign it, have it countersigned by two club members in good standing and submitto the Membership Chairperson.
  2. This application for full membership will be read and voted on at the next regular meeting.
  3. If voted into full membership,applicable yearlydues minus the $25.00 provisional membershipfee, will be due at that time. Applicant must attend meeting for application to be read.
  4. Applicant is responsible for all class fees until voted in as a full member of GTOTC.
  5. Club benefits will be instituted immediately upon voted on as a full member of GTOTC.

Type of Membership: (Check appropriate box.)

Individual Membership
(prorated at $4.50 a month) / $54 / Family Membership
(prorated at $5.50 a month) / $66 / Mail completed application form with payment made to "GTOTC" to:
Mona Horgan, GTOTC Membership Chairperson
326 Meridan Street, Pittsburgh, PA 15211
412-913-1482(C) and/or
Associate Membership
(prorated at $2.25 a month) / $27 / Junior Membership
(prorated at $2.25 a month) / $27

PLEASE NOTE: Associate members do not have the right to vote or hold office and are required to pay for all GTOTC classes and award plaques. Junior members (16 and younger) must have parent or guardian sign the waiver and they do not have the right to vote or hold office.

Please Type or Print Clearly

Last Name / First Name / Spouse
Street Address / City & State / Zip Code / E-mail Address
Home Telephone Number / Work Telephone Number / Occupation
Breed(s) of Dog(s) / Call Name(s) of Dog(s)

Previous Training Experience:

Name of Club or School / City/State

GTOTC Training Classes Attended:

Class Instructor(s) Date(s)

Class Instructor(s) Date(s)

List Club activities where youvolunteered your time and help:

______

Membership Liability Waiver

I (We) hereby agree to abide by the rules and regulations of the Golden Triangle Obedience Training Club, Inc. In obtaining my (our) membership and in participating in Club activities, I (we) hereby agree to hold the Club, its members, officers, agents, superintendents, committees and/or members thereof and all employees of said Club, in whatever capacity, harmless from any loss or injury which may occur to any persons or thing and/or which may be caused directly or indirectly to any person or thing from all hazards which may exist, including but not inclusive: conditions of floors, steps and stairways, floor coverings and walkways, electrical appliances and fittings and the presence of animals. All persons entering the Club's Training Building or attending any of the Club's events/functions for whatever purpose do so entirely at their own risk.

Signature(s) of Applicant(s): _ Date:

/ This Portion is Reserved for GTOTC Action /

Endorsed by: 1. ______2. ______Date Received: ______

Date Acknowledgment Sent to Applicant: ______

Dates Sent to Recall: 1.______2. ______3. ______

Revised 5/19/14

1029867

9999.0100