Japanese Chin Club of Greater Houston

                   If you are interested in joining our JCCGH club.
                     Family   $15                   Individual    $10              Associate    $7

Please copy  and send to :
                                Chris Lewis    2317 Steele St. Houston, TX    77098
                                                                 
Member Information Sheet

Name___________________________________________________________

Address_________________________________________________________

Telephone Number   Home________________________________________
                                      Cell__________________________________________

E Mail Address   _________________________________________________

Kennel name____________________________________________________

Circle all  that Apply:        owner,   exhibitor,  breeder,  obedience,  judge,    rescue
  Other _________________________

Are you a member in good standing with the AKC?     Y          N
Do you have other breeds?                                                Y          N
Are you a member/officer of any other dog clubs?       Y          N
Are you willing to serve on a committee?                       Y          N
Do you agree to abide by the Constitution, By-Laws, rules and regulations of the club and AKC?   Y   N


      Name________________________________________  Date____________________