|TOPEKA KENNEL CLUB
Dues: Single-$20.00; Family-$25.00
Other Family Members:___________________________________________________________
City State Zip Code
Phone: Home: (____)______________________; Cell: (_____)__________________________
Email Address: _______________________________________________________________
How would you like the Topeka Kennel Club Barker Newsletter sent to you?
(Circle One) Mail or Email
Breed(s) of Dogs Presently Owned:_____________________________________________
Past Breed(s) Owned:_________________________________________________________
The Topeka Kennel Club holds two licensed dog shows and a sanctioned match each year. Are you willing to work at
these events? (Circle One) Yes or No
Would you be interested in serving on a Topeka Kennel Club Committee?
(Circle One) Yes or No
Are you currently a member of any other Dog Club? (Circle One) Yes or No
Name of Club: ____________________________________________________
Past Memberships? (Please list): _______________________________________
How long have you been active in dogs? __________________________________
Areas of Interest: (Check all that apply)
Breeder: ______________________ Obedience: ________________
Conformation: _________________ Tracking: _________________
Pet: __________________________ Other: ____________________
Other Interests Outside of Dogs:
Why do you wish to join the Topeka Kennel Club?
The Undersigned agrees to abide by the Constitution and ByLaws of the Topeka Kennel Club, Inc. and by the rules and
regulations of the American Kennel Club governing dog shows and obedience trials.
Signature of Applicant(s): ___________________________________________
Date of Application: _______________________________
*Sponsor: _______________________ *Sponsor: _________________________
* A husband and wife are considered as one membership and can serve as one sponsor.
For Club Use Only:
Date of First Reading: ________________________________ Date Dues Paid: _____________
Date of Second Reading: ______________________________ Date Voted On: _____________
Votes: YES ________________ NO ___________________