PRT Club Membership Application Form

Title: ……… Name: ………………………………………………………………………………

Address: …………………………………………………………………………………………………………

Town: ………………………………………………………………

County/State: ……………………………………………………………… Post/Zip Code: ………………

Country: ………………………………………………………………

Email address: ………………………………………………………………

Telephone No:………………………………………………………………

I / We wish to apply for Membership of the Parson Russell Terrier Club as follows:

UK Junior - £3.00
UK Single - £10.00
UK Joint - £12.50
European - £15
Rest of World - £20.00

(Please delete as necessary)

I enclose the sum of £ ………………………………..….. NB All payment must be in pounds sterling.

Signed ……………………………………………………………… Date………………………………

*Proposed by ……..………………………………………………………….

*Seconded by …………………………………………………………………

*The Proposer and Seconder must be fully paid up members of the Parson Russell Terrier Club

When completed please send your form and the appropriate fees to:

The Membership Secretary: Mrs S Dolman 38 Chaseley Road, Rugeley, Staffordshire WS15 2ST

If you wish to give any information about yourself please use the reverse of this form.

Your application will be considered by the Committee of the Parson Russell Terrier Club at its next meeting. In the event of the Committee rejecting your application no reason will be given and no correspondence will be entered into Signing this form indicates your willingness to accept the Rules of the Parson Russell Terrier Club and The Breeders’ Code of Ethics. Copies of these documents can be obtained from the Secretary below or found on the web site.

SECRETARY 

Mrs Jane Newport,  Whitehills Farm, Shilton Road, Burford, Oxon. OX18 4PE

01993 822806