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APPLICATION FOR MEMBERSHIP
MEMBERSHIP BEING APPLIED FOR (check one only):
[] FULL MEMBERSHIP - I own at least one purebred Caucasian and I have signed the Breeder's Code of Ethics. I understand that having a Full Membership entitles me to a single vote in US COPS club issues. I understand that I must be approved by the Membership Committee before Full Membership status is granted, and until then, I will be considered an Associate Member. I understand that I need a sponsor (an US COPS Full or Family Member in Good Standing with the club) to be considered for Full Membership.
My US COPS Sponsor is:
_(Name)____________________________________(Phone)____________________
[] FAMILY MEMBERSHIP - We own at least one purebred Caucasian and we have both signed the Breeder's Code of Ethics. We understand that having a Family Membership entitles us to two votes, (except in A.K.C-related matters, in which each household only has one vote). We understand that we must be approved by the Membership Committee before Family Membership status is granted, and until then, we will be considered Associate Members. We understand that we need a sponsor (an US COPS Full or Family Member in Good Standing with the club) to be considered for a Family Membership.
Our US COPS Sponsor is:
_(Name)____________________________________(Phone)____________________
[] ASSOCIATE MEMBER - I/we either do not own a Caucasian, or we do not wish to sign the BCE. I/we understand that as an Associate Member, I/we may take full advantage of the educational benefits of membership in US COPS, but may not vote.
Please note: failure to complete this Application in full will delay your membership. All information is required unless otherwise indicated. Please complete all information requested. Falsifying information or failure to adhere to the BCE (if signed) can result in suspension of privileges or other administrative action.
NAME(S):_______________________________________________________________
ADDRESS:______________________________________________________________
PHONE:__________________________DAY __________________________EVE
EMAIL: __________________________
NUMBER OF PETS IN HOUSEHOLD: _______
NUMBER OF DOG BREEDS IN HOUSEHOLD: ________
NUMBER OF OVCHARKA IN HOUSEHOLD: ________
NUMBER OF CAUCASIANS IN HOUSEHOLD: ________
NAME OF VETERINARIAN:______________________________________________
PHONE NUMBER OF VET:_______________________________________________
If you do not own a Caucasian now, have you ever owned a Caucasian before?
[] Yes [] No
If "Yes", please let us know what happened to your CO(s): _______________________
_______________________________________________________________________
_______________________________________________________________________
Please feel free to let us know your experience with dogs in general, or with the Caucasian breed in particular, or include any other comments you'd like to make:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________ Please list three personal references who have known you in your dealings with animals. Please DO NOT list family members.
NAME RELATIONSHIP PHONE
1.______________________________________________________________________
2.______________________________________________________________________
3.______________________________________________________________________
č For Full Memberships, (1 vote) please enclose a check for $30.00.
č For Family Memberships, (2 votes) please enclose a check for $35.00.
č For Associate Memberships, (non-voting) please enclose a check for $25.00.
All fees must be in US funds.
Indicate amount sent: _________________________ Check #: __________________
Please make check out to "US COPS" and send Application, signed BCE and check to:
US COPS Treasurers Paul & MaryAnn Bolognese 183 Stone Mill Lane Marietta, GA 30064
For questions, please call Tamara Follett at Toll-free 1-866-347-1736, 8am - 9pm, EST or email at GuardianElite@aol.com
**Please note that membership approval may take a little time, please be patient.**
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