Regular Membership Application Test

AMERICAN CAVALIER KING CHARLES SPANIEL CLUB

APPLICATION FOR REGULAR MEMBERSHIP

Name

Address Line 1

Address Line 2

City

State

Zip

Email

Phone

Website

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.

Approximately how many shows do you attend per year?

Name up to 5 per year AKC Shows or performance events where you have exhibited your Cavalier in the last two years.

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

Name up to 5 AKC shows or performance events you have exhibited any other breed of dog in the l ast two years

How many AKC titles, obedience, Rally Agility, etc. do your dogs have? List titles and which breeds

Have you attended an ACKCSC National Specialty? Yes No

If so, which one(s)?

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?

How many Cavalier litters have you bred in the last two years?

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?

On what date was your Associate Application was approved?

Why are you interested in changing your status from Associate to Regular Member?

Please describe your VOLUNTEER efforts & other CONTRIBTUTIONS to the ACKCSC since becoming an Associate Member.

Please indicate what services you might be able and willing to provide and your areas of volunteer interest

Describe any academic, profes sional or personal achievements, experience or training with which you utilize to help the ACKCSC, Inc. to develop programs, meetings, publicity, public relations, or art.

Is there anything else you would like us to know about you or your dogs that you feel might be helpful to us in processing this application?

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 1 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

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 Regular Member Application

Please confirm that your sponors have completed their sponsorship form.

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


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The Application Process