Text Box:  
Indian Territories Australian Shepherd Club
ASCA, Inc Affiliate
Membership Form

     

 

 

 

Membership Types:       

                                                _______ Renewal     _______ New

____ Family        2 Votes

$15.00

____ Single         1  Vote

$12.50

____ Junior                         

$  5.00

 

Renewable annually-membership years run from December 1 through November 30.

New Members will be voted on at the next meeting and will be notified accordingly.

 

Name(s): ________________________________________________________________________

 

Address: ________________________________________________________________________

City, State, Zip: ___________________________________________________________________

ASCA Membership #: ________________________  Phone: ______________________________

Email: ______________________________
 

Areas of  interest?   Herding ___ Conformation ___ Obedience ___  Agility ___ Other_____________

 

Do you own or have access to stock? _____ Type: Cattle ____ Sheep ____ Ducks ___

Are you involved in any current disputes or disciplinary action with ASCA?_______

If so please explain:_________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

I, the undersigned, do hereby agree to abide by the Constitution, Bylaws, Registry Rules, Regulations, All Program Rules, Code of Ethics, and Dispute Resolution Rules of both ASCA and Indian Territories Australian Shepherd Club. Also, by renewing this membership in future years, I have deemed to have consented to all current terms of the Constitution, Bylaws, Rules, Policies, Procedures, and Dispute Resolution Rules of both ASCA and Indian Territories Australian Shepherd Club. The ASCA Information is available by writing the Australian Shepherd Club of America, P O Box 3790, Bryan, TX 77805-3790. The Indian Territories Australian Shepherd Club bylaws should be received with notification of membership acceptance.
 

Signed: _______________________________  Date: ___________________

 

Signed: _______________________________  Date: ___________________

 

Return this form with your check payable to: ITASC

Mail to: Shannon Gannon, 3309 Huntsman CT., Edmond, OK 73003  Phone: (405) 340-9033

We welcome members who are willing to help in any way.