Japanese Chin Club of Canada Inc (JCCC)

Japanese Chin Club of Canada Inc (JCCC)

Area of Operation: Canada

Membership Application Form – 1 form per person

Applicant name: ______

Applicant address: ______

Applicant email: ______Phone:______

Kennel Name: ______

I am a CKC member in good standing ______yes CKC# ______no ______

I am a member in good standing of the following dog clubs, kennel clubs, or professional organizations: ______

I have read, understand and agree to abide by the JCCC By-Laws and Code of Ethics, as posted on the JCCC website at:

I acknowledge that failure to adhere to the JCCC By-Laws and Code of Ethics may subject me to disciplinary review. I hereby declare that I meet all the JCCC by-law criteria for membership set out in the by-laws for the membership category selected below – please check one:

_____ Voting Class A member $25 OR _____ Non-voting Class B member $15

Mail your application with cheque or money order to:

Non-refundable membership application fee …………………………... $ 20

Membership dues for the current year (Jan-Dec) $25 OR $15 $ ____

Optional: JCCC Incweblink to your kennel website (Jan- Dec) $20 $_____

Cheque or money order enclosed, payable to: $_____

Japanese Chin Club of Canada Inc.

c/o Ms. Jamie Churchward, Treasurer

9639 Ottewell Road, Edmonton, AB, Canada T6B 2E3

or contact the Treasurer at (780) 299 1038 about an e-transfer

I understand and agree that if accepted for JCCC Inc membership, I cannot state in any advertising material of any kind (whether electronic or otherwise) that I am a member of the JCCC; nor will I make use of the JCCC logo. I acknowledge that a link to the JCCC website is permitted on my social media, as long as that link does not state or imply that I am a member, director, or officer of the JCCC. I consent to the use and disclosure of my personal information by the JCCC, for administrative purposes.

______

APPLICANT SIGNATURE Date: