2008 / 09 HBMDCNY DUES RENEWAL NOTICE
Due by April 30, 2008. Per Club constitution and By-Laws re-application is required for failure to renew membership by April 30, 2008.
Please make checks payable to HBMDCNY. We accept personal checks or money orders ONLY.
NAME(S)____________________________________________________________________
KENNEL NAME (if applicable)___________________________________________________
ADDRESS:__________________________________________________________________
___________________________________________________________________________
TELEPHONE (HOME) ________________________________
WORK__________________________________
E MAIL __________________________________________________________
DO YOU WISH TO PARTICIPATE IN OUR ON -LINE YAHOO GROUP LIST? ________
INDIVIDUAL VOTING MEMBERHIP - $20.00 FAMILY VOTING MEMBERSHIP - $25.00
ASSOCIATE NON VOTING FAMILY MEMBERSHIP $15.00
ALL members must sign the following pledge:
I pledge to abide by the Constitution and By- Laws of the club and the Code of Ethics.
I will promote the positive interests of the Bernese Mountain Dog to the best of my abilities.
sign____________________________________________________________________________
Please check off any that apply or interest you:
_____ Owner _____Breeder _____TDI _____Conformation
_____Tracking _____Draft _____Obedience _____ Agility
_____RallyO _____Match show _____ Fun stuff (walks, Parades, Picnics) _____Board of Directors
_____ Education _____Programs Other ______________________________________________
Any donation to the General Fund or Rescue is greatly appreciated.
Membership Dues __________
Gen’l. Fund __________
Rescue __________
Total Enclosed __________
MAIL TO: Nancy Bullard 949 County Rte. 59 Cambridge, NY 12816 Tel. 518-677-8682 Vistaplatz@aol.comDate: ______________
Please fill this form out completely, even if all your information remains the same. Thank you. If you have any questions feel free contact me.