I/We hereby apply for MEMBERSHIP in the
NORTHERN LIGHTS PRAIRIE REGION GSD CLUB

I/We agree to encourage and promote quality in the breeding
of purebred German Shepherd Dogs:  To do all possible to bring their natural
qualities to perfection and to promote responsible ownership through continuing education in all aspects of the breed


I/We include with this application, the Fee's for the following membership:

                                                                  ________      Primary Membership $35.00
                                                                   (Regular Voting Member), plus $5 for  each additional household member.

                                                     _________    Affiliate Membership ( non-voting ) $25.00. 

Any new member joining after September 1st of any calendar year, shall have their dues paid through December of the following calendar year.


If accepted I/We will uphold the Consititution and By-Laws of the Northern Lights Prairie Region GSD Club.


SIGNATURE  ___________________________________________________________________________________________


NAME: ________________________________________________________________________________________________


DATE: _________________________________________________________________________________________________


ADDRESS: ______________________________________________________________________________________________


CITY/TOWN _____________________________________________________________________________________________


POSTAL CODE: __________________            PHONE: _____________________________________________________________


E-MAIL _________________________________________________


KENNEL NAME: __________________________________________
(If Applicable)


CKC Member  No____  Yes ____  Membership # _______________


Sponsored by: (2) Members _________________________________

                                             _________________________________

My/Our main interest in German Shepherds is:

_____________________________________________________________________________________________

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Please Remit To:  Maureen C. Charlton
Site 22, Box 13, RR 8, Edmonton, Alberta. T5L4H8
Make cheque Payable To:  Northern Lights Prairie Region GSD Club