SOUTHERN WEST HIGHLAND WHITE TERRIER CLUB

APPLICATION FOR MEMBERSHIP

 

NAME(S): ……………………………………………………………………………………………………………...........................

 

ADDRESS: ………………………………………………………………………………………………………………………….........

 

………………………………………………………………………………………………………………………………………………..

 

POST CODE: ……………………………………………………….. TELEPHONE NO: …………………………............

 

Type of Membership (please tick): Single  Joint:  Junior:      Overseas: 

 

  • 1. Reason for wishing to join the S.W.H.W.T.C.: …………………………………………………………………………….
  • ……………………………………………………………………………………………………………………………………….
  • 2. How many WHW Terriers do you own? …………. Are they registered with the Kennel Club? Yes/No
  • 3. From whom did you purchase or acquire them? …………………………………………………………………………
  • 4. Do you have an Affix? Yes/No If yes, state name and dated granted, Affix: ……………………………………..
  • Date Affix granted: …………………………………..
  • 5. Involvement with dogs (please tick): Breeder  Pet Owner:  Exhibitor:  Obedience 
  • If Breeder, please list breeds: …………………………………………………………………………………………………
  • 6. Do you keep any of the above breeds solely for breeding:     Yes/No  If yes, state which breeds:
  • ……………………………………………………………………………………………………………………………………….
  • 7. Number of years involved with dogs as:  Breeder ……  Exhibitor ……  Pet Owner …… Obedience ……
  • 8. Please list membership of other Canine Clubs/Societies: ….......................................................................
  • ……………………………………………………………………………………………………………………………………….
  • 9. Do you agree to abide by the Constitution and Rules of this Club and the Rules of the Kennel Club? …….
  • 10. Have you read the Code of Ethics accompanying this Application? ………. Do you agree to govern your
  • conduct by its terms and spirit? ……………
  • DATE: …………………………………………………….. SIGNATURE(S): …………………………………………………………
  • Proposer’s Name: ………………………………………. Signature: ………………………………………………………………..
  • Seconder’s Name: ……………………………………… Signature: …………………………………………………………….....
  • Date received: …………………………………………..  Date approved: …………………………………………………………
  •  *JOINING FEE:   £10.00 Club Badge £2.00
  •  *ANNUAL SUBSCRIPTION UK:  Single £6.00 Joint £10.00 Junior £2.50
  •  *ANNUAL SUBSCRIPTION OVERSEAS: Single £10.00 Joint £16.00
  • Cheques should be made in sterling payable to: SWHWTC Amount Enclosed: £ ………………
  • Application form, together with the relevant amount, should be returned to: 

Hon Secretary: Mrs Marion Smewin, 6 Newcomen Drive, Tipton, West Midlands DY4 8XX 

Tel: 0121 520 9115  e-mail: marionwhwt@blueyonder.co.uk
*Initial payment is joining fee PLUS annual subscription.

  • THE ABOVE DETAILS ARE STORED ON COMPUTER FOR CLUB USE ONLY
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