Boise Australian Shepherd Club 2010 Membership Application http://www.boiseasc.net

Type of membership:

____Family $18.00 Includes 2 votes ____Single $15.00 Includes 1 vote   ____Junior $10.00  Non voting

Please print clearly or type: Name: _______________________________________________ Name: _______________________________________________ Name: _______________________________________________ Address: _________________________________________________________________________ City: _____________________ State: __________________________ Zip Code: ______________ Phone: _____________________________ Cell #: ___________________________________ E-mail: _______________________________________________________________________ Web site or URL #: ______________________________________________________________ Are you interested in the e-mail discussion group? ________Yes ___________No ASCA Membership #: ______________________ Exp date: ______________________

(Required for BASC voting membership)

Junior?s Name: ______________________________________________________________ Birth date: ___________________________________________ Junior?s Name: ______________________________________________________________ Birth date: ___________________________________________

Areas of interest: ____Agility ____ Conformation ____ Jr. Handling ____ Obedience ____ Other

Where can you help or committees you would like to serve on ____Agility ____ Conformation ____ Jr. Handling ____ Obedience ____ Fund Raising ____ Other

Agreement: By signing this application, applicant(s) agree(s) to adhere to the Constitution & Bylaws of the Boise Australian Shepherd Club and the Australian Shepherd Club of America (ASCA)
Signature: ________________________________________ Applicant: ________________________________________ Applicant: ________________________________________	Date: __________________________ Date: __________________________ Date: __________________________
Please send this application and fees to Mardi Price, 8748 Foothill Rd.  Middleton, Id.  83644 Please make check payable to the Boise Australian Shepherd Club

For Boise ASC Use Only:
Received by: _____________________________	Check #: ____________	Date: ______________