Great Lakes Rottweiler Club Application

First Name:

Last Name:

Address:

City:

State:

Zip:

Home Phone:

Work Phone:

E-Mail:

Occupation:

Kennel Name:

Family ($30.00):

Single ($25.00):

Associate ($15.00):

Type of Membership:

Please answer the following questions that apply:

How long have you owned rottweilers?

Co-Own?

How many male rottweilers do you own?

Do you intend to use your male at stud?

Is your male neutered?

How many females do you own?

Co-Own?

Do you intend to breed your female?

Is your female spayed?

Are you exhibiting now or do you intend to exhibit your rottweiler in AKC shows?

What about other registries? (CKC, UKC, etc.)

How many years have you exhibited rottweilers?

Do you have other interests (carting, herding, therepy, agility, etc)?

Yes:

Is your rottweiler(s) trained for Shutzhund?

No:

Other?

Is your rottweiler(s) trained for Attack/Guard?

No:

Yes:

Was your rottweiler purchased as a pet?

Yes:

No:

Yes:

No:

Show?

Do you have an affiliation in any type of animal related business such as a pet store, pet suplies, grooming, kennel, training schools, guard dog service, or act as a broker or agent?

Yes:

No:

If 'Yes' then please explain:

By submitting this form, I(We) hereby declare that I(We) are eighteen years of age or older, in good standing with the American Kennel Club and agree to abide by their rules and by the rules and code of ethics of this club which I(We) have answered the above questions in a true and accurate manner.

Application Date:

Please print a copy for your records.  If necessary, please mail to: Cheryl Hirons 8878 Morris Rd. Goodells, MI  48027 (586) 325-1433

Page Two of Application!