SETTER CLUB OF CANADA

MEMBERSHIP APPLICATION / RENEWAL FORM 2011

I (WE) hereby make application for membershe Irish Setter Club of Canada in accordance
with Article 1 of the Constitution and By-Laws and acceptance of the Club Principles of Integrity. I (WE) enclose the annual dues for the year.

Individual Membership: Open to all persons 18 years and older.   $25.00
Family Membership : Open to any two related or unrelated adults living in the same household and any minor children ages 10 to 17 years, residing with them. All are eligible to compete for annual awards. Youths under 18 years of age are not eligible to vote or to hold office as an Officer or Director. Only one copy of the Club Newsletter will be sent per Family Membership. $40.00
Junior Membership : Open to all persons 10 to 17 years of age. Junior members will be eligible to compete for the annual awards, but will not be eligible to hold office in the Club.  $10.00

Associate Membership: Open to all persons 10 years of age, and over,
sponsored by an Irish Setter Breeder, on receipt of an Irish Setter puppy. This membership is valid for one year, and is not renewable.

Residents of the United States must be Associate Members. Associate members are not eligible to vote on Club matters nor hold office, as per CKC Rules.  $15.00

Dues Are Payable in Canadian or US Funds

PLEASE PRINT

Name or Names __________________________________________________________

Address ________________________________________________________________

City Prov/State Postal Code/Zip __________________________    _________________

Phone / E-mail Address (___) ____________ /  _________________________________

Proposed By/Address __________________   __________________________________
Member in good standing of the following Irish/All-Setter or other club (s)
________________________________________________________________________

CKC# _____________________ ( If Applicable )

Please fill in these statistics, which have bearing on your eligibility:
How long have you been interested in Irish Setters? Do you have other breeds? ____/___

If yes, what breeds? Number of Irish Setters? _______________________________/___

Club Interests? ___________________________________________________________

Kennel Name/Tattoo# _______________________________/______________________

Have you previously been a member of the ISCC? circle:  YES   NO

I (we) hereby certify that I (we) are eligible for the type of membership applied for above. I (we) agree to abide by the Club Constitution, the Club Principles of Integrity and the membership application obligations of the CKC. This form is viewable online on our Club website, or can be mailed upon request.

___________________________________      __________________________________
Signature                                                            Date

I (we) also give my (our) consent to have my (our) name and other information  printed in the Club’s Membership List, and distributed via e-mail or as an insert with our newsletter to members only.

_________________________________          ______________________________
Signature                                                           Date

IF YOU WISH TO SUPPORT ISCC RESCUE, YOU MAY ADD THE DONATION OF YOUR CHOICE TO THE MEMBERSHIP FEE.   $ ___________  THANK YOU!

 Laureen Strellioff
RR#1 Craigmyle
Alberta T0J0J0

Kenerin@telusplanet.net

Please Send Cheque or Money Order payable to the Irish Setter Club of Canada with the 2 pages of this Application form (including the signed copy of the Principles of Integrity) to:
Last Amendment: 20 April 2011

Please Send Payment No Later Than May 01, 2011

We Appreciate Your Membership! Thank You.