ITALIAN GREYHOUND CLUB of GREATER HOUSTON, INC.

MEMBERSHIP APPLICATION

DATE: ____________________

Please check one:

_____ Full Membership $20.00
_____ Associate Membership $10.00 (non-voting)
_____ Junior Membership $5.00 (under 18 years of age)

(CHECK SHOULD ACCOMPANY APPLICATION — MADE PAYABLE TO I.G.C.G.H.)

(Please Print Legibly)

NAME: ________________________________________

ADDRESS: ________________________________________

CITY: ____________________ STATE: ____________________ ZIP: ____________________

HOME PHONE: (____)_________________________

WORK PHONE: (____)_________________________

FAX: (____)_________________________

EMAIL: ______________________________

SPONSORED BY: (Two members in good standing with the IGCGH, Inc.)

Member: ________________________________________

Member: ________________________________________

The information supplied below is for the past two year period. If you need more room,
you may write on the back of the application, or attach a separate sheet.

ITALIAN GREYHOUNDS OWNED, SEX, AND REGISTRATION NUMBER:

NAME / SEX / AKC#

1. ________________________________________ / _____ / _____________________

2. ________________________________________ / _____ / _____________________

3. ________________________________________ / _____ / _____________________

4. ________________________________________ / _____ / _____________________
Complete, including championships and/or obedience titles

ARE YOU A BREEDER? YES: _____ NO: _____ If yes, please complete the following:

NAME OF BITCH / LITTER REGISTRATION #

1. ________________________________________ / _____________________

2. ________________________________________ / _____________________

3. ________________________________________ / _____________________

4. ________________________________________ / _____________________

NAME OF STUD / # OF LITTERS SIRED

1. ________________________________________ / _____________________

2. ________________________________________ / _____________________

3. ________________________________________ / _____________________

4. ________________________________________ / _____________________

Initial: _____

HAVE YOU PARTICIPATED IN ANY OF THE FOLLOWING (in the past 2 years)?

CONFORMATION SHOWS ______ If so, how many? ______

SPECIALTY SHOWS ______ If so, what breeds? ______

OBEDIENCE TRIALS ______ # ______

FIELD and/or TRACKING ______

OTHER ______________________________

DO YOU OWN A KENNEL? ______ If so, what name? ______________________________

ARE YOU A PROFESSIONAL HANDLER? ______ If so, for what breeds? ______________________________

ARE YOU A LICENSED JUDGE? ______ If so, for what breeds? ______________________________

ARE YOU CURRENTLY A MEMBER OF ANY OTHER DOG CLUBS? ______
If you answered yes, please complete the following:

NAME OF CLUB(S): ______________________________

______________________________

OFFICE HELD: ______________________________

COMMITTEE(S): ______________________________

WOULD YOU SERVE ON COMMITTEES FOR THE IGCGH, INC.? ______
If so, what is your preference? ______________________________

WHY DO YOU WISH TO BECOME A MEMBER OF THE IGCGH, INC.?

____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

PLEASE READ THOROUGHLY AND SIGN WHERE INDICATED.

IF ELECTED TO MEMBERSHIP, I WILL ABIDE BY THE RULES AND REGULATIONS OF THE IGCGH, INC.

__________________________________________________
Signature of Applicant