Associate Member Form Test

AMERICAN CAVALIER KING CHARLES SPANIEL CLUB

APPLICATION FOR ASSOCIATE MEMBERSHIP

Name

Address Line 1

Address Line 2

City

State

Zip

Email

Phone

Are you over 18? Yes No

Occupation

Kennel Name

Is your Kennel Name registered with the AKC? Yes No

Is your kennel registered for any other breeds? Yes No

If so, please specify which one.

Have you ever had ethical charges filed against you or been suspended from the privileges of ANY dog club or the AKC? Yes No

If so, please describe with dates, club name and circumstances.

Are you a member of a local AKC CKCS organization? Yes No

If so, which one?

If so, what year did you join?

If so, describe your affiliation or involvement.

List all AKC recognized Kennel Clubs, Specialty, Obedience, Agility or Performance Clubs to which yo u belong, any position s you have held and dates of membership.

What year did you acquire your first Cavalier?

How many do you currently own?

When did you first exhibit in the AKC (any breed)?

Approximately how many shows do you attend per year?

List other breeds you have kept, bred, shown or judged.

Are you an AKC approved Judge? Yes No

If so, what breeds and/or groups?

Are you currently breeding dogs? Yes No

Which breed(s)?

Approximately how many litters per year?

Do you register all your litters/puppies with the AKC? Yes No

Do you register with any other registry? Yes No

If so, please specify which (ones)

What health testing do you routinely perform on your breeding dogs?

Have you attended an ACKCSC National Specialty? Yes No

If so, which one(s)?

Why do you want to join the ACKCSC?

What skills and special talents do you have that might be beneficial to the ACKCSC?

Name of Sponsor 1

How long have you known Sponsor 1?

Describe your relationship Sponsor 1.

Has Sponsor 1 been to your house/kennel? Yes No

Name of Sponsor 2

How long have you known Sponsor 2?

Describe your relationship Sponsor 2.

Has Sponsor 2 been to your house/kennel? Yes No

Have you bought a dog, co - owned a dog or bitch, used a stud dog or leased a bitch from either one of your sponsors? Yes No

If yes, please describe

Were dues paid? Online Check Mailed

Have you read and do you understand the Ethical Guidelines? Yes No

By answering yes, the applicant agrees to abide by the By Laws, Ethical Guidelines and the Rules of the American Cavalier King Charles Spaniel Club and the American Kennel Club, acting always in the best interest of the Club and purebred dogs. Furthermore, the applicant agrees to update any information required by the American Cavalier King Charles Spaniel Club, Inc. upon request. This application is subject to the approval of the Board of Directors of the American Cavalier King Charles Spaniel Club, Inc. The applicant and sponsors understand that their names will be published for members to submit comments to the Membership Committee. Should the application be denied, the ACKCSC Inc. is under no obligation to make known the reasons. Yes No

Thank you for filling out the Associate Member Application

Please confirm that your application fee has been paid. You can pay it through the online store at https://www.ackcsc.org/index.php/shop-ackcsc/member-dues/new-associate-member-dues or
Send a check payable to ACKCSC to:
Dee Wallis
6000 High Bluff Court
Raleigh NC 27612

Finally, please confirm that your sponors have completed their sponsorship form.

Your application will be processed after Payment and Sponsor Forms have been recieved.


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The Application Process