Membership Application

Questionnaire

NOTE: A reciprocal link is MANDATORY therefore if you currently have no website we cannot list you UNLESS a one-page website is ordered through us. A one-page website, is available for the nominal fee of $15.00/year. If yu currently have a website there is no fee whatsoever.

Please tell us all about you as a breeder:

Your name (s):
Your Kennel Name:
Address:
City:
Province/State:
Postal/Zip Code:
Home Phone ( * with area code * ):
Work Phone ( * with area code * ) :
Cell Phone ( * with area code * ):
Email (required): (eg-johndoe@aol.com):
Additional Email: (eg-johndoe@aol.com)*:
Website (if any):

Please list all the breeds you currently have:

Is your breed or breeds recognized with your country's recognized pure bred dog registry. Yes No

How many CKC &/or AKC Champions have you produced?

Where do you do most of your advertising?

Do you do health testing on your breed(s)? Yes No

If you do not health test, why not?

If you do health test please list any & all testing done or to be done on your breeding stock

Do you do Rescue? Yes No

Do you take back dogs you have produced if something happens to the owner or if the owner cannot keep them, no matter how old the dog is? Yes No

If not, why not?

Please supply at least one reference, preferably a longtime reputable breeder or a mentor. This is MANDATORY:

	Name	E-Mail Address
Reference #1

Any additional comments?