Sioux Empire Kennel Club - Membership Application

Are you submitting for a Household Membership? *

Yes

No

First Name (first member) *

Last Name (first member) *

Phone Number (first member) *

Phone Number (additional)

Email Address (first member) *

Name (second member)

Email Address (second member)

Phone Number (second member)

Street Address *

Address Line 2

City *

State *

Zip Code *

Dog Information

List the dogs you currently own with their breed and age. *

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What are your areas of interest for your dog(s)? Check all that apply *

Do you breed dogs? Yes/no and name of kennel? *

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Have you ever bred a non-registered litter? If yes, please explain: *

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Have you taken training classes at SEKC or elsewhere? Please list classes and facility *

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Please list any titles your dog(s) hold:

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Please describe any other dog activates in which you are or have been involved in.

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What is your previous club experience?

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Why are you interested in joining this club? *

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Have you ever been fined or suspended by the AKC or charged with violation of animal cruelty or neglect laws? If yes, please explain: *

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Club Information

I agree to abide by the Constitution and Bylaws of the Sioux Empire Kennel Club and I understand the duties and responsibilities of being a member. A copy of the Constitution and By Laws is available on our website or from the membership chair. *

I agree

You must have sponsorship from two (2) members of SEKC to be considered for membership. A few ways to meet sponsors is to attend general membership meetings which are open to the public or training classes.

Below, please list two members who are willing to sponsor you so they can endorse your application.

Sponsor 1's Name: *

Sponsor 1's email: *

Sponsor 2's Name: *

Sponsor 2's email: *

Membership Dues

Annual dues are $30 for an individual member; $50 for a household (no more than two adult/voting members); and $20 for junior member (17 years old or younger). Dues are payable before December 31st of each year.

The annual building code fee is $25 and due with membership renewals each year and will be sent to members pending Active status verification. However, if a new member achieves Active status during the calendar year they become a member, they can request the door code for that calendar year from the Membership Committee. To achieve and maintain Active status, members must volunteer at one Cub event or attend two general membership meetings.

If you elect to pay via check please mail your check to PO Box 719 Sioux Falls, SD 57101.

Are you applying between August 1-October 31? Dues are half price for applications in this timeframe. If applying between November 1-December 31, dues are full price and cover the next calendar year.

Yes

Please select your membership level:

Individual - $30

Household - $50

Junior Member- $20

Please select your membership level:

Aug-Oct membership- Individual - $15

Aug-Oct membership- Household - $25

Aug-Oct membership- Junior Member- $10

Current Total:

$0.00