Online Membership Application Form

Membership Level *

Member

First Name *

Last Name *

Address *

Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Telephone/Home *

Business

Cell

Email *

Are you currently a member of the CKC? *

Yes

No

Have you ever been sanctioned by the CKC, AKC or any other animal organization? *

Yes

No

If yes, please provide details in a separate letter to Yolande.

Participation – How would you like to participate in the club? Would you like to volunteer to help with:

Rescue Events

Waterlog

Website

Membership

Merchandise

2020 Specialty

Health Seminars

Water Work

Conformation

Obedience

Agility

Tracking

Flyball

Therapy

Education Seminars

Other (please specify)

Other

If you selected Other above, please specify.

Member Section To access the Member section of www.pwdcc.org, please provide your username (last name, first initial) and password. Note: both are case sensitive. Keep a record of both. You cannot change your username.

Username *

Password *

Family Membership Family membership is available at $35.00 for the 1st member and $10.00 for each additional family member.

Additional Member Name 1

Additional Member Name 2

Additional Member Name 3

Additional Member Name 4

Additional Member Name 5

Constitution and By Laws *

I Agree

By selecting “I Agree” and submitting this form I agree to abide by the Constitution and By Laws of the Portuguese Water Dog Club of Canada (www.pwdcc.org), the PWDCC Code of Ethics and the rules of the Canadian Kennel Club (www.ckc.ca, 416 675-5511).

Membership Application Form

Verification