PETERBOROUGH AND DISTRICT OBEDIENCE CLUB
MEMBERSHIP APPLICATION
Name(s):__________________________________________________________________________
PLEASE PRINT NAMES OF FAMILY MEMBERS APPLYING
Address: __________________________________________________________________
City: _______________________________
Phone: (Home) ___________________
Postal Code: ____________
(Cell-Optional): __________________________________
E-mail: _________________________________________
Are you a CKC member? ____ If yes, what is your number: ______________________
Breed of dog: _________________________
What training has your dog had? _______________________________________________
What courses have you attended? ______________________________________________
Have you attended obedience competitions? _____________________________________
Are you interested in further competitions? ________________________________________
Are you a member of other canine clubs or organizations? ___________________
Please list where you are currently training or have recently trained
_________________________________________________________________________________
Would you be interested in participating in (as a participant or helper):
Dog obedience lessons: ___
Dog seminars: ___
Dog match (open to all breeds, fun competition) once a year: ___
Dog trail (open to registered purebreds only) for titles once a year: ___
Author a publication article: ___
Other: ________________________
Are you a dog breeder? ___
Breed: __________________
I have read the PADOC constitution and by-laws (see attached) and agree to abide by them. I understand I will be an associate
member for a period of twelve (12) months. I understand that all members of PADOC are working members and are expected to
contribute their time and expertise as required and attend monthly meetings under the conditions of the by-laws.
A family membership (one that includes you, your spouse and family members) carries only one vote).
Date: _________________
Signature: _____________________________
Signature: _____________________________
FOR PADOC USE ONLY
Date associate joined: ____________
Membership confirmed: _______________
Special skills: ___________________________________________
Special interests: ________________________________________
Assistant Instructor: ___________________________________
Instructor: ____________________________________
Update of skills: __________________________________________________________