1

GREAT PYRENEES CLUB OF CANADA

CLUB DU MONTAGNE DES PYRENEES DU CANADA

Membership Application Form

Date______

Name(s)______

Address______

______

Telephone ( )______Fax ( )______

Email ______

Are you a breeder of Great Pyrenees?______

Since______

CKC Registered? ______

Kennel Name ______

Tattoo # ______

How did you first hear about this breed?______

______

What was your primary reason for purchasing a Great Pyrenees? (Circle One)

Companion Livestock Guardian Showing Breeding Family Protection

Where did you acquire your Pyr? (Circle One)

Registered Kennel SPCA/Pound “Backyard” litter(not registered) Pet Store

Previous owner did not want Gift Found Other______

Are you a member of other dog clubs? (Please List)______

______

What can the Great Pyrenees Club of Canada do for you?______
______

Were you referred by a GPCC member and if so who? ______

I agree to abide by the Constitution & Bylaws of the Great Pyrenees Club of Canada and of the Canadian Kennel Club. I am not currently under suspension by the Canadian Kennel Club or any affiliated breed club. I will ensure that all dogs under my care are kept in good condition and are protected from harm.

Signed______Date______

Signed______Date______

Cheques/Money Orders are to be made payable to the GREAT PYRENEES CLUB OF CANADA. Mail the fees and this completed and signed Membership Application Form to the Club Treasurer;

Katherine Goliboski, GPCCanada

20 Sunset Ave.

Brantford, Ontario

N3T 5G2

All new applications will be published in the next quarterly issue of the PYR’N’ROUND newsletter for approval by the membership. Applications which are accepted shall become “Associate Members” (non-voting) 60 days after publication. “Associate Memberships” will be upgraded to “Active Members” (voting) after one full year of membership in the Club. Membership renewals are due on December 31st of each year. Late membership renewals will lose their “Active Member” status, and will revert to “Associate Members”, if dues are received after the final January 31st grace period.

Current Membership Fees

Individual applicant $30.00

Each additional applicant $10.00

at same address

In addition to my membership fee, I have included a donation of $______for the GPCCanada to be put towards the following special projects –

______CANINE TRUST FUND (for health care research)

______NEWSLETTER COSTS (printing, mailing, etc.)

______TITLEHOLDERS (photo record of Pyrs with pedigrees)

______HISTORY (to research the breed’s beginnings in Canada)

______AWARD DONATION (in memory of ______)

______GENERAL FUND

______OTHER ______

Page 1 of 2