Directions for applying for membership:

Print and sign the "code of ethics".

Attend one club functions.

Initiation fee is $5.00.

Annual dues: family $20.00; couple $15.00; single $10.00.

Newsletter subscription is $7.50.

Make a check out for the appropriate type of membership to Mason Dixon BMD Club

Send your completed membership package (application, Code of Ethics and membership check) to the membership chair:

Jackie Caracciola
Mason Dixon BMD Club Membership
1495 Bonbar Road
York, PA 17403

(717) 848-1348

Please Note: New members are automatically placed on provisional status until their application is voted on and approved by the club at the next regularly scheduled meeting.

Membership fees will be refunded to any applicants declined by the club.

MEMBERSHIP APPLICATION

Name:___________________________________________________
Mailing Address:___________________________________________
Phone: __________________________________________________
eMail:___________________________________________________

Occupation: ______________________________________________
Have you ever been suspended from the AKC?____. If so, state the dates and circumstances_________________________________________
When did you first acquire a Bernese Mountain Dog?__________________
Was it a pet or show quality BMD?_________________________________
When, if ever, did you exhibit BMD's?___________________ Other breeds?___________________________________________________
Within the past five years, have you been a breeder, exhibitor, and/or judge of BMD's?___________________________________________________
Are you currently involved in breeding, showing, tracking, or doing any other formal activities with BMD's?__________________________________
List all other kennel clubs, obedience or specialty clubs to which you belong and indicate any positions held in these clubs:______________________
Do you derive income from the dog fancy other than from the sale of puppies or stud service?___ If yes, specify and explain:_____________________
Are you able to accept committee or other assignments if requested?___
What are your areas of interest in club work?______________________
___________________________________________________________
Average number of BMD's kept by the applicant?_______________
Number of litters of BMD's whelped in the last 3 years?__________
Number of puppies in the last 3 years?_______________________
List some of your BMD's who have earned titles in conformation, tracking, obedience, agility, etc.____________________________________
List any other breeds with which you are involved_______________
Are you currently a member of the National BMD Club or any regional BMD clubs? If yes please list:___________________________________
In the space provided, please explain why you wish to be a member of the Mason Dixon BMD Club and what you could do for the club:

Bernese Mountain Dog owned currently: (please list all additional dogs on a separate sheet of paper)
Name:_________________________________ DOB:_________
AKCNumber:_____________Breeder: __________________ OFS:____
Sire: _________________________Dam: __________________

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I have read the questions set forth on this application and have answered truthfully and fully. I understand that should this application be disapproved, the Mason Dixon Bernese Mountain Dog Club is not obligated to make known the reason to me.

Signature of Applicant:
Date: