Member's Gender FemaleMaleOtherPrefer not to sayYour gender

Member's Year of Birth Before 19621962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013Your year of birth

Member's Address The first line of your address including building number and street

Town/Suburb Your postal town or suburb

Postcode Your postcode

Dog Name Your dog's name

Dog breed Your dog's breed

Additional Info Any other info you wish to provide to the Club

Volunteer roles Chairperson Committee member Head Trainer Honorary VP Kennel Club Liaison Membership Secretary President Secretary Trainer Treasurer WebmasterSelect one or more volunteer roles

JUNIOR APPLICANTS ONLY My parent/guardian agrees to me joining the Club and I will be accompanied by a responsible adult at all training sessions and other Club events/activitiesApplicants for Junior membership ONLY must tick the box to agree to the above.