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 COPY OF AKC REGISTRATION CERTIFICATE
***PLEASE ALSO PROVIDE A COPY OF THREE GENERATION AKC
PEDIGREE IF SIRE AND DAM ARE NOT 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
870 BARREN VALLEY RD
CHUCKEY, TN 37641
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