Name(s):                                                                                                                                    

Address:                                                                                                                                       

Home Telephone number:                                                                                                           

Number of dogs in household:                  How many different breeds:                                   

What breeds other than Kerries:                                                                                                

Name of Kennel if any:                                                                                                                     
Enclosed is a check or money order for the sum of (Circle one):  

          $20.00 Associate membership per person

          $25.00 Associate membership per couple in same household

          $25.00 Active membership per person

          $35.00 Active membership for two in the same household

We agree that these fees are for our first year’s membership dues and if we are declined 
for membership, the money will be refunded.

SIGNATURE:                                                                                                 DATE:                         

SIGNATURE:                                                                                                 DATE:                         

SPONSOR SIGNATURES OF TWO MEMBERS:                                                    

                                                                                                                                                    

Note:  Active members shall have full voting rights as long as they are members in good standing, as prescribed in the current by-laws and constitution. 

Please contact any officer for the address to return the application along with your check for the amount listed.      Officer contact information is posted on the club website Home Page.

http://kbtctx.org/