Membership Application Form

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Membership Application

*First name

*Last name

*Membership Type

Household #2 First Name

Household #2 Last Name

*Email

*Phone

*Address

*Sponsor Name

*Sponsor Email

*Sponsor Phone

Would you like to participate in our Membership List?

*Are You A Member Of The SBTCA?

Yes

No

*Are You In Good Standing With The SBTCA?

Yes

No

*Are You In Good Standing With AKC?

Yes

No

*Has The AKC Ever Taken Actions Against You?

Yes

No

*Has Your Membership Ever Been Denied, Suspended, Or Revoked By A Club?

Yes

No

*What Are Your Interests?

Conformation

Performance

Companionship

Rescue

*How Many SBTs Do You Own?

1

2

3

4+

*Why Would You Like To Join HSBTC?

*Please share a photo of yourself for the Heartland Howl newsletter, shared with HSBTC members.

Please include all members in your photo; dogs are optional but welcomed.

HSBTC Specialty Judges

Optional- Please submit judges you would like added to the HSBTC Specialty Judges List for future consideration.

HSBTC Speciaty Judges

I Affirm That I Will Adhere To The HSBTC By Laws And Code Of Ethics And The Regulations Of The American Kennel Club. I Understand The Consequences Of Non-Compliance.

*Pay For Membership

Regular Membership$40

Household Membership$50

Associate Membership$20

Junior Membership$0

Donation

$10

$20

$30

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