NVBC Membership Application

Membership participation in NVBC events is key to the success of our events and of the club as a whole.

We have two types of membership available for one, two or three years before renewing:

 Active Member (Voting) $30.00 for one year; $60.00 for two years; or $90.00 for three years - With your paid membership you receive an automatic membership in the American Brittany Club and you receive the monthly American Brittany Club magazine and the NVBC newsletter. You are eligible to vote for board of directors, nominate, and run for an elective office.
 Associate Member (Non-voting) $3.00 for one year; $6.00 for two years; $9.00 for thre years - Open to any family member or significant other of an active member.

Print form, fill-in information and mail with check to address below:

Name:
Mailing Address:
City:                                                                                          State:               Zip Code:
E-mail:
Phone:(_____)_____________________                          Cell:(_____)________________
Names of Other Members:
Number of Brittanys:_____   Brittanys Names:
Interests: (Check all that apply)
   ___ Agility      ___ Breed Shows  ___ Field Trials   ___ Breeding  ___ Pet
   ___ Fun Trial  ___ Hunt Test        ___ Obedience   ___ Social      ___ Other
(Check as applicable)
I (___am) (___am not) an active member of the American Brittany Club.
This is a (___)new (___) renewal NVBC membership.

I agree to support the NVBC goals, to participate in club activities, volunteer in support of the club, and to promote cooperation and friendship among my fellow Brittany owners.

_____________________________________________                   ______________
(Applicant Signature)                                                                     (Date)

Applying For:

Full Membership $30 - 1 Yr $60 - 2 Yrs $90 - 3 Yrs

Associate Membership $3 - 1 Yr � $6 - 2 Yrs $9 - 3 Yrs

Total Submitted: $ ______

Make check payable to: NVBC
Send check with application form to: Judi Parker, NVBC Membership, 1453 Wasp Lane, McLean, VA 22101

Updated October 12, 2010

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