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NORTHEAST  ENGLISH  COCKER  SPANIEL  CLUB

APPLICATION FOR MEMBERSHIP

There are three types of membership available in the NECSC:

Voting Member - Attends at least one meeting and assists with at least one activity in a two year period of time.

Associate Member - Does not have voting rights and is not expected to attend one meeting and assist with one activity in a two year period of time.

Junior Member - Is 12 to 16 years of age and does not have voting rights.

I am applying for (Circle one):     Voting Member           Associate Member              Junior Member

NAME: ____________________________________________________________

STREET ADDRESS: __________________________________________________

CITY/STATE/ZIP: ____________________________________________________

TELEPHONE NUMBER (with area code): __________________________________

E-MAIL ADDRESS: ___________________________________________________

DO YOU PRESENTLY OWN AN ENGLISH COCKER SPANIEL? _____________

WHAT OTHER BREEDS DO YOU OWN? _________________________________

WHAT OTHER BREED OR KENNEL CLUB DO YOU BELONG TO?  LIST ANY
OFFICES YOU HAVE HELD OR PRESENTLY HOLD IN THOSE CLUBS: _______
_____________________________________________________________________
_____________________________________________________________________

WHAT NORTHEAST ENGLISH COCKER CLUB FUNCTIONS HAVE YOU ATTENDED
OR PARTICIPATED IN? ________________________________________________
_____________________________________________________________________

DO YOU PARTICIPATE IN:   BREED SHOWING?  __________________________
                                                  OBEDIENCE TRIALS? ________________________
                                                  FIELD TRAINING? ___________________________

PLEASE LIST ANY ACTIVITIES YOU ARE INTERESTED IN PARTICIPATING IN,
SUCH AS CONTRIBUTING TO THE NEWSLETTER, ORGANIZING TROPHY
AND/OR LUNCHEON DONATION, CONTRIBUTING FOOD FOR LUNCHEON
BUFFETS, HELPING WITH THE SEMI-ANNUAL FUN MATCHES ___________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

Please send completed Application, your membership fee, and the signed Acceptance Procedure to:

Cortney Oliver  -  Box 791  -  So. Wellfleet, MA  02663

Check or money order (made payable to the Northeast English Cocker Spaniel Club) 
in the amount of:

$20.00 Voting & Associate Members

Additional Family Member(s) $5.00

If there are additional family members included in your membership, list their name(s) and any children's respective ages:
_____________________________________________________________________
_____________________________________________________________________

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