Internet Application Form

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NORTHERN DISTRICTS ROTTWEILER CLUB OF NSW INC

APPLICATION FOR MEMBERSHIP

NAME: (Mr/Mrs/Miss/Ms)
ADDRESS:
EMAIL:                                                  PHONE No:
RNSWCC No:                                        KENNEL PREFIX:

I/We apply to the NORTHERN DISTRICTS ROTTWEILER CLUB OF NSW INC., for membership as: -

Single Membership: Must be 16 years of age or older. FEE: - $27.50 plus $5.50 joining fee.
Dual Membership: Must be 16 years of age or older. Entitled to one (1) vote each. FEE: - $38.50 plus $5.50 joining fee.
Concession Membership: Available to pensioners aged 60 & over. FEE: - $11 plus $5.50 joining fee.

Junior Membership: Covering any individual under 16 years of age. A junior member is not entitled to vote or hold office. FEE: - $5.50 plus $5.50 joining fee.

ROTTWEILERS OWNED:                                      PET NAME:


(If further space required, please attach a separate sheet)

Enclosed is MY/OUR Cheque/Money Order/Cash for $___________ being for SINGLE/DUAL/CONCESSION/JUNIOR membership

*please make Cheques payable to the NORTHERN DISTRICTS ROTTWEILER CLUB OF NSW INC.

I/WE agree to be bound by the Constitution of the NORTHERN DISTRICTS ROTTWEILER CLUB OF NSW INC., and comply with all its Rules & Regulations.

SIGNATURE (S): ___________________________DATE:________________

  ___________________________DATE:________________

Membership starts at 1st July of each year. Membership fees paid after the 31st December in any one financial year shall be entitled to one half of the annual fee plus joining fee (for SINGLE membership $19.25, for DUAL membership $24.75, CONCESSION $11.00 & JUNIOR $8.25). Membership will only be accepted at a General Meeting with a majority vote of ¾ of members voting.

Please send completed form to: -

The Secretary
  Mrs Sue Oldfield
  51 Oakville Rd
  EDGEWORTH NSW 2285
  Ph 02 4950 8864

ALL FEES INCLUDE 10% GST