Please print, fill out and submit

Application for Membership

Name _____________________________________________________ Date ________________

Address ________________________________________________________________________


Phone (home, work, Cell): __________________________________email: ___________________

Check all activities in which you are interested:

Breed _________ Showing _________ Obedience _________ Breeding _________ All _________

Do you own a Boxer now? __________Have you ever bred a litter? __________

Would you be interested in serving on a committee, recognizing the fact that a club needs participation from
all of its members? __________

If elected to membership, do you agree to abide by the Club’s Constitution, by-laws and the rules of the
American Kennel Club? ________

Membership Category: (Please circle one)

1. $10.00 Single membership (18 years of age or older — one vote)

2. $5.00 Junior Membership (14-17 years of age with no voting privilege)

Sponsors (2) ______________________________ ______________________________


Applicant’s Signature ______________________________

Please return this application to your sponsor with the appropriate fee and it will be presented at the next scheduled meeting.


Thank You and Welcome