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2008 Membership Application
Please accept my application for 2008 CdECA membership as follows (check one):
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One Vote |
$ 30.00 |
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Two Votes |
$ 50.00 |
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One Vote |
$ 100.00 |
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Two Votes |
$ 100.00 |
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One Vote |
$ 200.00 |
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Two Votes |
$ 200.00 |
*Family: Any two adults residing in the same household.
The membership year is from January 1 through December 31.
The Gold and Diamond Memberships allow individuals to help the Club preserve the ancient form and dignity of the Cirnechi. These members will be recognized on our web page, in all listings of membership, and in the annual specialty program.
Name(s) ________________________________________________________________
Street / Mailing Address____________________________________________________
City___________________________ State____________________ Zip_____________
Home Phone ______________ Mobile ______________ Fax Number ______________
Occupation __________________________________ E-mail: _____________________
May we contact you at work? ____YES ____NO Work Phone ____________________
May we share your telephone with club members? ____YES ____NO
Do you own a Kennel? ____YES ____NO
Renewing Members:Stop here and mail this application along with your check for the appropriate membership fee to: Anne Mitchell, Corresponding Secretary, Cirneco dell' Etna Club of America, 12006 Aintree Lane, Reston, VA 20191.
New Members:Please continue completing the remaining questions on this form, and the Code of Ethics and mail them along with your check for the appropriate membership fee to : Anne Mitchell, Corresponding Secretary, Cirneco dell' Etna Club of America, 12006 Aintree Lane, Reston, VA 20191. Acceptance of membership will be acknowledged via E-Mail.
Please make your checks payable to CdECA.
I agree to sign and uphold the Code of Ethics for this club. (Return signed copy with this application.)
Signature I
_________________________________________________________________________
Signature II
_________________________________________________________________________
Please mail this completed application, the signed Code of Ethics, and a check for your membership fee made out to CdECA to: Anne Mitchell, Corresponding Secretary, Cirneco dell' Etna Club of America, 12006 Aintree Lane Reston, VA 20191.
For any questions telephone (703) 860-6727 or e-mail .
New Members only, please continue:
Name(s) ________________________________________________________________
Please list two CdECA members who endorse your membership.
_________________________________________________________________________
_________________________________________________________________________
(Use a second sheet of paper, or back of application for answers if needed. )
How did you find out about the Cirneco dell 'Etna?
_________________________________________________________________________
_________________________________________________________________________
What attracted you to the Cirneco dell 'Etna?
_____________________________________________________________________
_____________________________________________________________________
Please list your Cirnechi:
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Call Name |
Sex |
Date of Birth |
Registration Number |
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Check the following that apply to you and your Cirnechi:
Please describe your involvement with other breeds, current to past, including number of champions. Clubs you belong to and committees you have worked on. List names and breed of all dogs living with you.
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Would you be willing to work on a committee?
______________________________
What are your areas of interest?
_____________________________________________________________________
Additional Comments:
_____________________________________________________________________
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