New England Celtic & ABKC

Membership Application/Renewal Form

                                  FEES:      Joining fee  $5
                                           Single/couple/family  $5 per year

  NAME (Mr/Mrs/Ms)  ______________________________

#2 Name  ______________________________________
 

#3 Name  ______________________________________

#4 Name  ______________________________________
 

ADDRESS  _____________________________________

_______________________________________________
 

________________________________ Postcode  __________________

Telephone  ____________________Mob__________________ 

Email  ______________________________________________________

Breed/s  _____________________________________________

Breeder's Prefix (if any)  _______________________________

RNSWCC Membership Number/s (if any)  _________________

 
I/We hereby agree to abide by the constitution and regulations
of the New England Celtic and All Breeds Kennel Club

 #1 Signature  ___________________________Date  ______________

 #2 Signature  ___________________________Date  ______________

Amount Included:    $  __________________

Please post this form, along with your remittance to:

New England Celtic and All Breeds Kennel Club
The Secretary
S Fawcett
"Fourways"  4000 Kelvin Road
RANGARI  NSW  2380                                 Ph: 02 6743 3534

Or, you can Direct Credit our bank account:  Please contact Secretary for Bank Details

 Please make sure you put your name in as a reference, otherwise we will not be able to trace your payment. 
And, don’t forget to send us the completed application/renewal form!
 

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