Sagebrush Dog Club
Membership Form
___________________________________________________________________
Sagebrush Dog Club follows the UKC belief that you should have fun with your dog
Applicant Name ____________________________________________________
Street Address ______________________________________________________
City, State _________________________________________________________
Zip ______________________________________________________________
Phone # Day ( ) __________________ Eve ( )___________________
Email Address _____________________________________________________
Which type of membership are you applying for?
_____ Single Membership - Open to members 18 years of age or older. Single members are entitled to one vote
and are eligible to hold office in our association. $15 per year
_____Family/Household membership - Open to any two members of a household 18 years of age or older. Each
Family/Household membership is entitled to two votes but only one
member may hold office at any one time. $20 per year
_____Associate Member - Open to members 18 years of age or older. These members enjoy all the privileges of the association except that they do not attend meetings, vote, or hold office. $15 per year
Tell us about your dogs
1) Breed / Variety _____________________________________________ UKC Registered? _____yes _____no
Name (call and registered) _____________________________________________ Titles earned _______________________
2)Breed / Variety _____________________________________________ UKC Registered? _____yes _____no
Name (call and registered) ________________________________________ Titles earned ____________________________
3)Breed / Variety _____________________________________________ UKC Registered? _____yes _____no
Name (call and registered) ________________________________________ Titles earned __________________________
4)Breed / Variety _____________________________________________ UKC Registered? _____yes _____no
Name (call and registered) ________________________________________ Titles earned ___________________________
List any additional dogs on back
What type of activities do you participate in?
___Conformation ___Obedience ___Agility ___Rally Obedience ___Dog Sport ___Dock Jumping
___Terrier Racing ___ Hunting ___Total Junior ___Weight Pulling ___Other ________________________________
What type of activities would you like to participate in?
___Conformation ___Obedience ___Agility ___Rally Obedience ___Dog Sport ___Dock Jumping
___Terrier Racing ___ Hunting ___Total Junior ___Weight Pulling ___Other________ __________________________
What areas would you be willing to help with?
___Newsletter ___Board Member ___Conformation Steward ___Obedience Steward
___Set up and tear down of show ___Information Booth at sponsored show ___Fun Match
___Other ____________________________________________________________
By signing this application I agree that I have read and understand the by-laws and agree to adhere to them.
Your Signature __________________________________ Date ______________________
Please mail completed form with a check for membership dues made out to Sagebrush Dog Club to:
Sheila Gilles
2218 S Corona Ave
Colorado Springs, CO 80905-2850
