£ Membership Renewal £ New Membership Application

NAME: Telephone:

ADDRESS:

SUBURB: Postcode:

Email Address:

ANKC Affiliate Membership No:

£ Conformation £ Breeding £ Obedience £ Agility £ Tracking

£ Aussie Rescue £ Herding £ Companion £ Flyball £ Other

I/We hereby apply to become a member of the Australian Shepherd Association of NSW Inc and in consideration of your acceptance of my/our application I/we hereby agree to observe, perform and in all respects to conform to and be bound by its constitution and rules as amended.

Signature of Applicant: Signature of Co-Applicant:

Date: Kennel Name:

Joining Fee New Members $ 5.00 £

Single $20.00 £

Junior / Single Concession Membership (Copy Required) $10.00 £

Dual / Family Membership $30.00 £

Web Page Breeder List (Annual July to June) $ 5.00 £

Web page and inside newsletter advertise a dog (Annual) $35.00 £

Half Year Single Membership January to June Plus Joining Fee $15.00 £