Membership Application
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Name *
Email *
Mailing Address *
Phone Number *
Is this a New Membership or a Membership Renewal? *
Membership Type: *
Breeder Kennel Listing
Clear selection
If this membership is part of a Breeder's Litter Package, please list your Breeder and the Sire/Dam of your puppy below:
Breeder Name & Sire/Dam of Litter
If this is a Family Membership, please include second member's information below:
Name
Email
Phone Number
Special Interests: *
Required
Special Interests: *
Required
Are you interested in working on club committees? *
Are you a member of the Canadian Kennel Club (CKC)? *
Payment Method (in Canadian funds) *
I have read the MASCAN Code of Ethics and agree to abide by this Code and the MASCAN Bylaws as set forth at: https://miniatureamericanshepherdsofcanada.com/code-of-ethics and https://miniatureamericanshepherdsofcanada.com/by-laws. I also agree to permit the information supplied on this form to be used by MASCAN in its normal course of operation. This information will not be sold nor disclosed outside of the MASCAN Membership. Membership in the club is non-transferable, and membership dues are non-refundable (as stated in the Bylaws section 3, subsection f). I agree to the above statement. *
Please type your full name(s) - this serves as your E-Signature
On this date *
MM
/
DD
/
YYYY
Are you a Regular Member or a Breeder Member? *
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