| Membership Application Name:__________________________________________________________________ Address:_________________________________________________________________ City:________________________________Country/State:_______________________________Postal/ZipCode:_________________ Phone:__________________________________ Signature:_______________________________________________ Breed/s of dog/s:( 1 )__________________________________ ( 2 )________________________________ ( 3 ) ___________________________________ In the future would you be interested in applying to be a licensed tester/judge for the American Dog Federation ? ( )Yes ( ) No Current interests in : ( ) Conformation ( ) Personal Protection ( ) Schutzhund ( ) Search & Rescue ( ) Tracking ( ) Obedience Novice ( ) Obedience Advanced ( ) Agility ( ) Other______________________ There is a one time membership fee of $10.00. Members receive a $10.00 discount on each testing. You do not have to be a member of the American Dog Federation (ADF) to Register Your Dog, or, to have your dog tested however all dogs tested for ADF titles must be registered with the ADF. Payment Options: ( ) Check ( )Credit Card ( ) Money Order ( )Visa ( ) Master Card ( ) Discover ( )Money Order ( ) Check Total$________________ Print name as it appears on credit card_____________________________________________________________________ Credit Card #_________________________________________________Expiration Date:________/_________/_________ By Signing Below the credit card holder authorizes the above charges to be charged to the credit card account number above Signature:___________________________________________________________Date:__________________ This is a Printable Page Please send payment with the completed application to: American Dog Federation 919 lakewood farmingdale Road Howell, New Jersey 07731 Questions: 989-644-0410 Monday thru Friday 9:00AM-5:00PM |
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