BCSA Membership Application

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Please complete this form to apply for BCSA Membership. If you would like to be considered for an individual/full or household membership, please ensure your sponsor also submits their form, as described later in this application. Review all information carefully before pressing “Submit Application.”

If you have any questions, please reach out to Lori Buxton, Corresponding Secretary.

* = Required Information

Email *

First and Last Name *

Address, including Street Address, City, State and Postal Code *

Best Telephone Number *

Best email address *

Occupation

Birthday (ONLY Month/Day)

Do you agree to accept meeting notices and Club information via email? All Club correspondence will come from CorrSecy@BorderCollieSociety.com. We will not sell your personal email address. *

Yes

Membership Agreement: Check all the apply. *

I/we agree to comply with the Code of Ethics, to support the Constitution and Bylaws and to strive to fulfill the Mission and Vision of the Border Collie Society of America.

Yes. By selecting this box, I/we confirm that it has the same effect as our personal signature(s).

Required

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