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Please complete this form and send it along with your subscription/bankers order form to: -
The Gen. Secretary: Miss Debbie Crewe, 14 Spittal Farm, Wigton, Cumbria CA7 0EP.
Telephone: ++ 44 (0)1 697 349 796
Note that no receipt will be issued
unless a SAE is enclosed with the completed form.
I/We hereby apply to become a member of the CHESAPEAKE BAY RETRIEVER CLUB and
I/We agree to abide by the Rules of the Club.
(Please use a black pen or biro
and write in BLOCK CAPITALS)
Date of Application:_____________________________
Name(s): ____________________________________________________________________________
Address:_____________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Postal Code: ____________________________________
Telephone: _____________________________________ Fax: _________________________________
E-mail: ______________________________________________________________________________
Proposer: ___________________________________ Seconder:________________________________
(Proposer and Seconder must be fully paid up members of the club.
If you do not know anyone who is a
member of the Chesapeake Bay Retriever Club, please speak
to the Gen. Secretary
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Annual Subscriptions
| Single £9.00 pa |
Joint £12.00 pa |
Overseas £10.00 Sterling per annum
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Payment is due on the 1st January each year.
Method of payment (please tick): |
| Bankers Order.........** |
Cheque.............. |
Postal Order......... Cash............ |
| All to be made payable to "CBRC" |
**If you wish to pay by Bankers Order, a form will be sent to you upon request.
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Please indicate your interests:
Field Trials......... Working Tests............ Training Days.............
Obedience.............. Shows.......... Agility............ Breeding...............
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