MEMBERSHIP APPLICATION

ANNUAL $10.00

LIFETIME $30.00

NAME____________________________________________________________

ADDRESS__________________________________________________________

CITY_______________________STATE_________________ZIP______________

PHONE ( NOT REQUIRED)________________

EMAIL (NOT REQUIRED)_______________________________________________

YOU MUST BE A MEMBER TO REGISTER YOUR DOG

DOG REGISTRATION APPLICATION

DOG REGISTRATION FEE $10.00

CURRENT OWNERS NAME_______________________________________________________

OWNERS ADDRESS_____________________________________________________________

CITY_________________STATE________________________________ZIP________

DOGS REGISTERED NAME__________________________________________________

***PLEASE PROVIDE A THREE GENERATION AKC PEDIGREE COPY**

NOT NEEDED IF SIRE AND DAM ARE IFBC of A REGISTERED

SIRE_______________________________________(if IFBCofA REGISTERED)

DAM________________________________________(if IFBCofA REGISTERED)

LIFETIME MEMBERSHIP FEE AND DOG REGISTRATION $40.00 TOTAL

ANNUAL MEMBERSHIP FEE AND DOG REGISTRATION $20.00 TOTAL

MAIL TO:

INTERNATIONAL FRENCH BRITTANY CLUB OF AMERICA

PO BOX 104

PETTIBONE, ND 58475-0104