SURNAME....................................................INITIALS..................MR/MRS/MISS/MS

ADDRESS............................................................................................................

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POST CODE………………………..PHONE NUMBER (inc STD)……………………….

NAMES OF ROTTWEILERS OWNED DATES OF BIRTH

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Proposed by (Club Member).............................................................................................

Seconded by (Club Member).............................................................................................

I agree to be bound and comply with the Club rules, from time to time in force. I further agree to be bound by and comply with the Code of Ethics, made by members in General Meeting, from time to time amending or replacing the same.

Signature of applicant(s).........................................Date.....................

In order to comply with the data protection act, we hereby advise you that members names and addresses are held on computer disc. Please indicate below whether or not you have any objection to us doing this purely for the running of the Club.

YES..........................NO.....................

SUBSCRIPTION RATE IS £10.00

PLEASE SEND THIS FORM WITH YOUR SUBSCRIPTION (CHEQUES/POSTAL ORDER NOT CASH) TO Mrs. Joyce Summers,64 The Quarries, Boughton Monchelsea, Kent, ME17 4NJ

Membership £10.00 Joint or Single. Please make cheques payable to

"THE ROTTWEILER CLUB"

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