Date:____________________ New Member: ________ Renewal: ________

____ Single Membership $15.00
____ Family Membership $20.00
____ Junior Membership $5.00

Name(s): ___________________________________________________________________ Address: _________________________________________ Kennel Name: ______________
City: ______________________________ State: _______________ Zip: ________________
Home Phone: ______________ Work Phone: _______________ Fax: ___________________
Email: __________________________________
Are you a member of ASCA: No Yes
What are your main areas of showing interest? _______________________

Please check any committees you may wish to serve on in the future:
Newsletter___ Herding___ Conformation___
Obedience___ Agility___ Nominations___
Seminars/Clinics___ Other (please specify)_______________

I (we) agree to abide by the Constitution, Bylaws, Rules, Regulations, Code of Ethics, and Dispute Rules of both ASCA and Heart of Texas Australian Shepherd Club.
Signature: ____________________ Signature: ____________________
Date: _____________________

Any Suggestions?