Pet Name Date of Birth Pet Name Date of Birth

MEMBERSHIP GROUP(Tick appropriate box)

SINGLE JUNIORDUAL FAMILY

MEMBERSHIP TYPE(Tick appropriate box)

RENEWAL NEW

NOMINATED BY:Signature:SECONDED BY:Signature:

FEE 1 Jul – 30 Jun $35 Full Year: 1 Jul – 30 Jun $40Half Year: 1 Jan – 30 Jun $20

Special Offer for Puppy Buyers from RRC Members BREEDERS RATE Full Year: 1 Jul – 30 Jun $30

(Breeder pays on behalf of Puppy Buyer) Half Year: 1 Jan – 30 Jun $15

AIR MAIL RATES Plus $10 Singapore and New ZealandFor Overseas Members Plus $20 All Other Countries

TOTAL REMITTANCE $ Please forward application form with remittance in favour of the Club to above address

THE RHODESIAN RIDGEBACKCLUB INC. www.therhodesianridgebackclubinc.com

13 Taringa St ASHFIELD NSW 2131MEMBERSHIP FORM 2011-2012

NAME/S:Family Children Names:POSTAL ADDRESS:

State: PostCode: Country:Telephone: Home: Work: Email:

Do you own a Ridgeback?What is your Kennel Prefix (If applicable)

Yes No Are you a

List all RRs owned. Write overleaf if more space required.

Family up to 2 adults and any number of children under 16 years; Junior – 12 to 16 years

I / We hereby apply for membership of The Rhodesian Ridgeback Club Inc. and agree to pay forthwith the appropriatesubscription and fees, and during my / our membership, to abide and be bound by all Rules, Constitution, Regulationsand Code of Practice which may be determined from time to time.I / We accept the obligation to protect, promote and advance the interests of the Breed and it’s Standard.I / We have read and accept the RRCI New Code of Practice ,approved November, 2009

SIGNATURE/S:_____________________________________________________________________________

* Renewals must arrive at the Clubs address BEFORE the 31st August otherwise will be treated as a New Application(Constitution Clause 11) and $40 fee will apply

Cash / MO / Cheque detailsbyReceived by Club on:

Membership Renewal Due 30 June