Date Rec’d __________

Date App’d __________

Date Treas __________

Amount Ck __________

Check # ____________

Membership # ________

 
Icelandic Sheepdog Association of America

Application for Chapter Membership

 

 

Return To: 

Knox Rhine

7 Kansas Court

Newton, KS 67114

 
 

 

 

 

 


Date:  __________________________

Chapter Name: ___________________________________________________

Secretary’s Name: ____________________________________ Home phone: ______________________

Address ______________________________________________________________________________

City ________________________________________________ State _______________ Zip __________

E-Mail ________________________________________   Work phone ____________________________

 

Chapter’s interest or focus (check each item that applies):

Agility ______ Obedience ______ Breed Education ______ Flyball ______ Rally ______ Rescue ______

Conformation ______      Other____________________________________

Current number of members?______  Year Chapter was formed? _______

 

Formal Chapter__________  or  Informal Chapter _________  Region_____________________________

 

Briefly describe the chapter’s reasons for seeking ISAA Chapter Membership.

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

 

Attach a list of your members in good standing. (Chapter members must be members of the ISAA.)

 

This application must be signed prior to submission.  The chapter name will be published in the ISAA Newsletter. 

A chapter is a regional and not a national organization.  The above named chapter hereby applies for Chapter

Membership associated with the Icelandic Sheepdog Association of America, and if accepted, agrees to abide

by the ISAA Constitution, ISAA By-Laws, ISAA Code of Ethics, ISAA Breeders’ Code of Conduct and the Rules

and Regulations of the American Kennel Club.

 

On behalf of the applying chapter, I have read and signed The Code of Ethics, the Breeders’ Code of Conduct

and the Educational Guidelines of the ISAA.  I have enclosed $10 for annual Formal Chapter membership dues.

(Checks should be made payable to: Icelandic Sheepdog Association of America.)

 

 

 

______________________________________________________

(Chapter President’s Signature and Date)

 

Print Name __________________________________ Home Phone _______________ Term Years _____

Address ______________________________________________________________________________

City ___________________________________ State __________________  Zip ___________________

E-Mail _________________________________________

 

 

(Date and attach signed Code of Ethics, Breeders’ Code of Conduct and Educational Guideline.)