MEMBERSHIP APPLICATION

GREAT NORTHERN ROTTWEILER CLUB

Membership Application

(This form may be photocopied)

Name:________________________________________________________________________________

If family membership, other member(s) name(s):______________________________________________

_____________________________________________________________________________________

Address: ______________________________________________________________________________

______________________________________________________________________________

Phone (Home):______________________________ Work:_________________________________

E-mail: _______________________________________________________________________________

What are your main interests? (Check all that apply.)

_____ Breeding _____ Conformation _____ Search and Rescue _____ Protection _____ Tracking _____ Obedience

_____ Herding _____ Carting _____ Agility

_____ BST _____ Therapy Dog

Other__________________

List all dog club affiliations (local, national or foreign):_________________________________________

_____________________________________________________________________________________

ANNUAL DUES (renewal in _______________) Current USRC member?

_____ New member $100 _____ yes

_____ Renewal $50 _____ no

I (We) will abide by the USRC Standard for the Rottweiler (FCI Standard 146/10.06.2000/D) and will only breed to males/females that comply with this standard. Further, I (we) will only breed to Rottweilers that have been certified by OFA, FCI (A and B), GDC or that have been certified HD- or HD+/- by the ADRK and are at least two years of age. I (We) understand that these are conditions for becoming and remaining member(s) of both GNRC and the USRC.

Signature:______________________________________________ Date:________________________

All new members must be endorsed by two current GNRC members in good standing.

Signature:______________________________________________ Date:________________________