Sioux Empire Kennel Club - Membership Application Revised April 2024

Are you submitting for a Household Membership? (Limited to two adult members residing in the same household.) *

Yes

No

First Name (first member) *

Last Name (first member) *

Phone Number (first member) *

Phone Number (additional)

Email Address (first member) *

Occupation (first member) *

Name (second member)

Email Address (second member)

Occupation (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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Please list any titles your dog(s) hold: *

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

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

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

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Do you breed dogs? Yes/no and name of kennel and average number of letters per year. *

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Have you ever bred a non-registered litter? No/Yes If yes, please explain: *

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Have you ever been fined or suspended by the AKC or charged with violation of animal cruelty or neglect laws? No/Yes 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.

In order to sponsor a new member, sponsors must have been a member for 12 months and be an "Active" member.

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 (two adult/voting members living at the same residence); 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

SEKC Use Only

Dues received on Date: ___________________ Check Number: __________

Eligibility Requirements verified on Date: ____________

First Reading Date: ____________ (Applicant must be present.)

Second Reading and Aopproved for Membership on Date: ____________ (Applicant must be present.)