Weimaraner Club Of SA Inc - EST 1976
Membership Form

                                  WEIMARANER CLUB OF SOUTH AUSTRALIA INC.
                                 APPLICATION FOR MEMBERSHIP & MEMBERSHIP RENEWAL 2006/ 2007


NAME(S): ..................................................................................... DATE: ....................... 

ADDRESS: .................................................................................... POSTCODE ................. 

TELEPHONE: ...........................….... EMAIL: ..................................................................

I/We hereby apply for NEW MEMBERSHIP/ MEMBERSHIP RENEWAL Signature/s ..........................................

YOUR INTERESTS: Showing, Obedience , Tracking, Pet / Companion, Retrieving / Field Trials,  Agility,

Other ...................………………


MEMBERSHIP FEES: (Please circle desired membership type ). 

RENEWAL: Double $25.00 Single $20.00 Pensioner $18.00 

NEW: (plus a car sticker) Double-$30.00 Single-$25.00 Pensioner $23 

CAR STICKERS AVALIBABLE: $3.00 each 

FINANCIAL YEAR: 1st October to 30th September 

DETAILS OF WEIMARANERS OWNED (please complete to the best of your knowledge)

Pet Name: .................................................................. D.O.B. ...................... Sex: .............

Pedigree Name .............................................................. Tattoo Number: .............................

Pet Name: .................................................................. D.O.B. ...................... Sex: .............

Pedigree Name .............................................................. Tattoo Number: .............................

Pet Name: .................................................................. D.O.B. ...................... Sex: .............

Pedigree Name .............................................................. Tattoo Number: ............................. 

Microchip Number.............................................................



APPLICATION / RENEWAL FOR STUD DOG & BREEDERS REGISTER

STUD DOG REGISTER (fee $5.00 per Stud Dog) 1st October to 30th September

Name of Stud Dog ..............................................................................................................
Sire ................................................................................................................................
Dam ...............................................................................................................................
Whelped ........................... Hip Score (ie 3:3) .......... Copy of Hip score report provided to WCSA Inc
Owner(s) .................................................... Telephone .....................................................
Address ......................................................................................... Postcode ..................

BREEDERS REGISTER (fee $5.00 per Kennel Prefix ) 1st October to 30th September

Kennel Prefix ................................…........... Owner(s) ......……...........................................
Address ......................................................................................... Postcode ...................

Telephone ................................…............... Email ...........................................................

Web Page Address............................................................................................................. 

If you have Broadband and wish to have the Newsletter emailed YES / NO .

If yes please add email address if diffrent to above .................................................................


RETURN FORM TO: The Treasurer, 18 CLARENCE AVE, KLEMZIG, SA 5087 _