NWFCRC Membership form for 2021

Northwest Flat-Coated Retriever Club

New Membership Request Form
Name*

First NameLast Name
Spouse or Partner

First NameLast Name
Email*
example@example.com
Alternate Email (if desired)
example@example.com
Phone Number*
This number is my*
Alternate Phone Number (if desired)
This number is my
Address*

Street Address

Street Address Line 2

CityState

Zip Code
What is your preferred method/s of contact?

EmailPhoneTextLetter
Who is sponsoring your membership into the NWFCRC?
Sponsoring Member
If you are a breeder, what is your Kennel name?
If you are a breeder, would you like your kennel name listed in the Member Roster?

Yes, please.No, thank you.
How many years have you had with Flat-Coats?
What activities are you interested in? Check all that apply.

AgilityConformationDock DivingField ClassesField Events/HuntingFlyballFun Days/PicnicsHandling ClassesNose WorkObedienceRallyTherapy DogTracking
How many Flat-Coated Retrievers do you have?
Please list them below.
My Flat-Coats*
List any accomplishments that you would like to share with other members about your dog/s, or your Flat-Coat experience.
Do you have any thoughts or comments about what you would like to see the NWFCRC offer?
Would you be willing to volunteer occasionally to assist with some club events?

Yes, I am willing to help occasionally.No, not at this time
Would you be willing to serve on a committee, or as a committee chair?

Yes, I may be willing to chair a committee.Yes, I may be willing to help by serving on a committee.No, not at this time.
Would you be interested in helping your sub-regional committee plan events for your area?

Yes, I would be interested.Maybe, but I would like more informatioin about what this would entail.No, not at this time.
Would you be willing to serve on the NWFCRC Board of Directors? Since our membership is spread across 5 states, the Board meets once a month by conference call or online conference, so distance is not an issue. We will be happy to mentor anyone who is interested!

Yes, I would like to help as a board member.Maybe, but I need more information about what this would entail.No, not at this time.I am currently serving as a board member.
Membership Option Desired
prevnext( X )
Single Membership$20.00

Family Membership$30.00

Youth Membership (under 18 years of age)$10.00

Total $0.00
By clicking the Submit button below, I/We agree to abide by the rules and regulations of the American Kennel Club and its member club, the Flat-Coated Retriever Society of America, Inc., including its Code of Ethics. I/We further agree to abide by the Constitution and Bylaws of the Northwest Flat-Coated Retriever Club.
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Northwest Flat-Coated Retriever Club