APPLICATION FOR MEMBERSHIP OF AN INCORPORATED CLUB
AFFILIATED WITH THE V.C.A. INC.

Application for membership of the THE WELSH CORGI CLUB OF VICTORIA INC.

Mr / Mrs / Miss / Ms …………………………………………………………………………………..
(Name of Applicant/s)

of ………………………………………………………………………………………………………..
(Address)

………………………………………………………. (Phone) ………………………………………..

Email …………………………………………………………………………………………..........…

desire to become a …………………............ member of the Welsh Corgi Club of Victoria Inc.
(single / dual)

If admitted as a member / members in the above category, I / we agree to be bound by the constitution and by-laws of the Club, and by the constitution, rules, regulations and Code of Ethics of the VCA Inc.

……………………………………………………………………………………………………………
(Signature /s of Applicant /s)

Date……………………………………

I, ……………………………………….. a member of the Welsh Corgi Club of Victoria, nominate the applicant/s who is / are known to me, for membership of the club.

           ……………………………………………..
             (Signature of Proposer)

Date……………………………………….

Send to:
Membership Secretary
Mrs G. Cherry
P.O. Box 102
Pakenham Victoria 3810
Single: $20.00 Dual: $30.00
Junior: $10.00 If a sole member.

OFFICE USE ONLY
Date admitted as member/s in the above category....................................................................................................................

Membership Secretary..............................................................................................................................................................