LAKE MICHIGAN CARDIGAN CLUB (LMCC)
                                                                      APPLICATION FOR MEMBERSHIP


Name ...............................................................................................................................

Address ............................................................................................................................

Phone ......................................................... Kennel ...........................................................

E-mail ..............................................................................................................................

Webpage ...........................................................................................................................

LMCC sponsor(s) ................................................................................................................

Choose type of membership (check one):

Regular Voting Membership
          ..... Family...................... $15.00
          ..... Single....................... $10.00
          ..... Jr 10 thru 17 yrs........... $ 5.00

Associate Non-Voting Membership
          ..... Family .................... $ 7.50
          ..... Single ..................... $ 5.00
          ..... Jr. 10 thru 17 yrs ........ $ 2.50

Make check/MO payable to Lynn Griner and send to:

Lynn Griner (LMCC Membership)7532 East "W" Ave., Vicksburg, MI 49097
Ph#: (616) 649-0758 e-mail: peacheslg@hotmail.com

Please fill out the following information, use seperate sheet(s) of paper if needed:
1. How many AKC registered Cardigan Corgis do you currently own?
Reg/Call Name(s) (optional):............................................................................................
2. Do you exhibit at AKC shows? Y N
3. Are you a member of any other breed, or obedience clubs? Y N Please list:
.......................................................................................................................................
4. Have you at any time been associated with a wholesale, broker or retail canine operation (pet shop)? Y N
5. Have you ever been suspended by the AKC? Y N If so, give details on seperate sheet.

I/We hereby apply for membership in the Lake Michigan Cardigan Club and if accepted agree to abide by itıs Constitution, By-laws, Rules and Regulations.

Signature of Applicant:................................................................... Date: ..............................

Signature of Applicant:................................................................... Date: ..............................

If you would like to help with LMCC activities or events, please list your interests and/or the talents you would like to volunteer on a separate sheet of paper . THANKS!