join_now.ews

Club Registration Form:

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SEE BELOW FOR PAYMENT TERMS

· MEMBERSHIP FEE - $36* (1 Dog) $12 (each additional dog

· Membership expiry date is 31st December each year, initial joining is pro-rata per quarter.

· Eg. $9 per quarter (1 dog) + $3 per quarter per additional dog.

Owner Details

Name:*

Address:*

Phone No(H):*

Phone No(W):

Phone No(M):

Email Address(H):*

Email Address(w):

Number of Dogs

Dog Reg`d Name #1:*

Nickname #1:

Breed#1:

Dog Reg`d Name #2:

Nickname #2:

Breed#2:

Dog Reg`d Name #3:*

Nickname #3:

Breed#3:

Walk- Day - am/pm #1:

Walk- Day - am/pm #2:

Walk- Day - am/pm #3:

Collection Details

Collection:

Key Req`d:

Please enter the security code shown

DO NOT PRESS Send

If you would prefer to pay by Cheque.

Print out this page and attach your cheqe and post to

LORD NELSON CLUB FOR DOGS

PO BOX 5686 GCMC QLD 9726

OR:

PHONE LEN OR KATE ON: 1300 551 886

AND WE WILL DO IT ALL FOR YOU!