NAME: _____________________________________________________

STREET ADDRESS: _____________________________________________________

CITY, ST, ZIP _____________________________________________________

PHONE: _____________________________________________________

E-MAIL: _____________________________________________________

KENNEL NAME: _____________________________________________________

SPONSOR #1: _____________________________________________________

SPONSOR #2: _____________________________________________________

I (we) herewith submit this application along with the initiation fee of $10.00 plus dues of $15.00 ($35.00 for family membership) for the first year, and agree to abide by the Constitution and By-laws of this the Interstate Shetland Sheepdog Club (ISSC.)

1. How many Shetland Sheepdogs to you own? _______

2. How long have you been active in the breed? _______

3. How many Sheltie litters have you bred? _______

4. Are you a dog show exhibitor? _____ Yes _____ No

Please check off all activities to which you have exhibited.

_____ Breed/Conformation _____ Obedience _____ Agility _____ Herding

5. Please list other dog club affiliations

_____________________________ ______________________________

_____________________________ ______________________________

6. Please explain why you would like to join The Interstate Shetland Sheepdog Club.

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

7. In what activities are you most interested?

________________________________________________________________

8. What duties or club activities are you willing to assume?

_______________________________________________________________

Signature (s): __________________________________________Date:_______________