Gold Country Irish Red and White Setter Society
Founded 2009
Membership Application: Household: $20 Individual: $15
Junior: $10 Associate/Newsletter: $15
Name:______________________________________________________________
Address:____________________________________________________________
_____________________________________________________________
Phone: __________________________E-mail: _____________________________
Kennel Name or prefix:_________________________________________________
Can all of the information above be published on the Membership List?_ Yes No (What do you not want published?)
Dogs: ______________________________________________________________
______________________________________________________________
Occupation: _______________________
Occupation:________________________
Family/Partnership list both
Activities: Show: Hunting: Obedience: Agility: Rally: Any Other:_________________________________________________________
Willing to serve on Committee : yes no
Signature:____________________________________ Date: ______________
The applicants agree to abide by the club constitution and bylaws and the rules of the American Kennel Club.
Signature: ____________________________________ Date: ______________
If Family/Partnership, both individuals need to sign.
Sponsor : _________________________Sponsor: __________________________
GCIRWSS Members in good standings – they don’t need to sign, just list their names.
Mail to:
GCIRWSSBarb Steinheimer, Secretary
1410 Mettler Road, Lodi, CA 95242