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APPLICATION FOR MEMBERSHIP
Annual Subscriptions: Single £8.00 Joint £10.00
Please Print Clearly
Name(s) (Mr./Mrs./Miss/Ms: .................................................................................................
Address: .............................................................................................................................................
...............................................................................................................................................
...............................................................................................................................................
Post Code:...................................................... Telephone Number:.....................................................
Affix (if any):...........................................................................................
Association with dogs:............................................................................
Signature:.............................................................................................
Proposed:................................................................... Seconded......................................................
(Proposed and Seconded MUST be fully paid up members)
I/We Undertake to abide by the constitution, rules & code of ethics of The Akita Association
The information given on this form will be stored on computer and in accordance with the Data Protection act. I/We have no objection to this information being used in any way that the committee of the above Association deem acceptable.
The committee will consider your application at its next meeting and notify you accordingly
Please return this form together with your remittance (Made payable to The Akita Association) to:
The Membership Secretary :-
Mrs. Doreen Harris:
89 Dunkirk Avenue, Greets Green, West Bromwich, West Midlands B70 0EX