Come and Join Our Club!!!!
Central Florida Australian Shepherd Club
Membership Request Form
Name___________________________________________________________
Address_________________________________________________________ City_____________________ State_________ Zip______________
Phone (_____)___________ E-mail___________________ A.S.C.A #________
Check here if this is a renewal:_____
MAIN INTEREST RELATIVE TO THE AUSTRALIAN SHEPHERD:
_______Conformation ______Obedience _____Agility _____Herding _____Breeding _____Tracking ______Other
MEMBERSHIP: Check type of membership you desire:
$15.00______ Dual-couple or parents and or minor child ( 2 votes)
$12.50______Single-one adult (1 vote)
$10.00______Junior-one child 10-17 years of age, non voting
$ 8.00______Subscription only-one per household, non-voting
I/We the undersigned, do submit this application for membership in C.F.A.S.C. and herby agree to abide by its constitution and by-laws. I/We also understand that all membership applications
are brought before the board for approval.
Signature____________________________________ Date:_______________
Signature:____________________________________Date:_______________
Make check payable to C.F.A.S.C.
All membership checks must be separate and not combined with entries
Send to Cathy Pirtle (treasurer)
487 S.W Powell Glen
Ft.White, FL 32038
Membership includes a free listing (at your request,) of your kennel information on our website
http://www.cfasc.com
Print out membership form and mail with dues.
Thank You!
Mail Bob, SFASC President
