Associate Member Form

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AMERICAN CAVALIER KING CHARLES SPANIEL CLUB APPLICATION FOR ASSOCIATE MEMBERSHIP

Name*

Address Line 1*

Address Line 2

City*

State*

Zip

Phone

Are you over 18?*

Yes

Occupation*

Kennel Name

Is your Kennel Name registered with the AKC?*

Yes

Is your kennel registered for any other breeds?*

Yes

If so, please specify which ones.

Have you ever had ethical charges filed against you or been suspended from the privileges of ANY dog club or the AKC?*

Yes

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

Are you a member of a local AKC CKCS organization?*

Yes

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

If so, what breeds and/or groups?

Are you currently breeding dogs?*

Yes

Which breed(s)?

Approximately how many litters per year?

Do you register all your litters/puppies with the AKC?*

Yes

Do you register with any other registry?*

Yes

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

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

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

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

If yes, please describe

Were dues paid?*

Online

Check Mailed

Have you read and do you understand the Ethical Guidelines?*

Yes

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

Associate Membership