Membership Application

Joanna Yeomans Membership Chair

10372 Indian Road
Gloucester, VA. 23061
703-554-2773
membership@gspca.org

If you prefer to pay by check, please download appropriate form and mail to Membership Chair with your check.

DO NOT TAKE THIS FORM TWICE. Only one membership per email address. DO NOT OVERWRITE INFORMATION. If you have more than one membership please contact the Membership Chair. If you are renewing your membership, use the Renewal Form.

Membership Type

Membership Options

Automatically Renew

Automatically Renew Membership

Printed Journal

Add Printed Shorthair Journal

No thank you, the electronic journal is sufficient.

Name

First Last

Second Family Member

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Country Phone Number

First Partner Phone

Country Phone Number

Email(Required)

Second Email

First/Second Member Name

First Partner Email

Second Phone

Country Phone Number

Occupation

Are you interested in sharing your talents on a Committee or for an event?

Participation Interests

Years Owning GSP

Have your privileges with the American Kennel Club or your membership in any dog club ever been refused, suspended or revoked?

Yes

If YES - state reason

Please list any other dog clubs to which you belong

How did you hear about the GSPCA?

Please list the Breeder Name, Sponsor and/or Referred by (For our records only, not required for membership)

Membership year is from January 1 thru December 31. All payments must be in U.S. dollars. I certify that I am 18 years of age or over. If accepted as a member, I agree to abide by the Constitution and By-Laws of the German Shorthaired Pointer Club of America, the GSPCA Code of Ethics and the rules and regulations of the American Kennel Club, of which the German Shorthaired Pointer Club is a member Parent Club.