OK-NAVHDA

12446 Blue Meadow, Guthrie OK 73044

email:  treasurer@oknavhda.com

Name:________________________________________________________________

Spouse/Children:________________________________________________________

Address:_______________________________________________________________

Phone(s)  Home:______________   Work: _____________  Cell: ______________

Email:__________________________________________________________________

Type of NAVHDA experience, if any:___________________________________________

________________________________________________________________________

NAVHDA International Membership #___________________________________________

Are you willing to help at chapter functions, if so, what areas would you like to work in?

________________________________________________________________________

Type of Dog(s) Owned:_____________________________________________________

Do you want to restrict your name and information from club publications? Yes[ ] or No [ ]

I, (name) __________________________________________________________ of

(address) ____________________________________________________________________

hereby request membership in the OK-NAVHDA chapter.  As a condition of membership dues in the local chapter and NAVHDA International must be current.  As a member, I agree to abide by the bylaws and principles of NAVHDA and all state and local game laws.  As an ambassador of this club, I will act with courtesy and respect and adhere to the rules of good sportsmanship.

Signed __________________________________   Date ____________________________

Membership:  Regular - 1 vote   Family - 2 votes   Junior (under 18) - 1 vote

________ Payment attached:  Cash___________   Check_________________

Membership Dues:

  Regular $30.00 _______  Family $40.00 _______  Junior $10.00 _______

Remember ANNUAL Membership Privileges expire September 1.