Date:.............................

Name :	...........................................................

Address :...........................................................

	...........................................................

	...........................................................


Phone/fax :	.........................  Email:..........................



Subscriptions:  Joint                               NZ$ 15.00
                Single                              NZ$ 10.00
                Overseas Postage Surcharge          NZ$ 10.00

Note:  Joint membership is two persons living at the same address.
Overseas Postage surcharge does not apply to Australia.


Payment to be made in New Zealand Dollars.
Bank Drafts or other to be made payable to "English Setter Club"

Complete this section if you are a Breeder and have a registered Kennel

Name of Kennel: ..............................................

Note:  If you do NOT wish your kennel details published in the
Breeders/Kennel Newsletter listing,
circle NO here.