COCKAPOO CLUB OF AMERICA
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PLEASE TYPE OR PRINT CLEARLY
Single Membership, $29.00 Family Membership $39.00*
Application must be signed and include a check payable to "Cockapoo Club of
America".
Name(s):_________________________________________________________________________________________
(as you would like it to appear on the membership card(s))
Address:_________________________________________________________________________
City:__________________State:_____________Zip Code:__________Country:____________
Telephone:____________________Fax:_____________________Email:______________________
How did you hear about the CCA?
Breeder____ Magazine Ad____CCA Member____ Web____
Other________________________
Do you own a Cockapoo?___Yes___No Please
list the registered name(s) of your Cockapoo(s)___________
_____________________________________________________________________________________
List on back of form if you need more room.
Would you like a set of forms to apply for the official CCA Registry to register your Cockapoo(s)? Yes____No____ (When it opens in the future.)
Are you a Cockapoo Breeder?___ Yes___No Would you like a set of forms to register your Cockapoos with the official CCA Registry?___Yes___No (When it opens in the future.)
I hereby apply for membership in the Cockapoo Club of America; I agree to abide by the objectives and purposes stated in the CCA Constitution and Bylaws posted on the CCA website at www.cockapooclub.com.
Signed:_____________________________________________________Date:_________________
Please enclose a check or money order for annual dues, made
out to Cockapoo Club of America for $29.00 single membership or $39.00 family
membership, in U.S. dollars. Thank you for
supporting the Cockapoo Club of America! We have been approved by the IRS
for 501(c) (4)
status as a non profit corporation and are tax exempt, but your
contributions or gifts are not deductible as charitable
contributions for Federal income tax purposes. Please note Breeder lists are included with the membership packet (free) for no
additional fee. Breeder list with information packet alone is $10.00
without CCA Membership.
*Family membership is limited to two persons per
household. Both applicants must list their names above.
Membership may be terminated, suspended or refused by the CCA Board of
Directors for any conduct that may be considered likely to prejudice or damage
the image or interfere with the efficient running of the Club or compromise the
breed in any way.
Click
here to read about
Cockapoo Club of America, Inc. Membership benefits