IOWA HERDING DOG ASSOCIATION MEMBERSHIP APPLICATION/RENEWAL
New Member _____ Renewal _____
Date _______________________
Name:
__________________________________________________________
Address:
________________________________________________________
City, State, Zip:
___________________________________________________
Phone:
__________________________________________________________
E-mail:
_________________________________________________________
Yes, please send me club
material via e-mail (saves printing and postage costs): _______
No, I need materials to
be sent to me via the postal service (regular mail): _______
Code of ethics
Signed
__________________________
Signed:
___________________________
TYPE OF MEMBERSHIP
(Check one)
□ Individual (one adult, one vote) $15.00
□ Dual (two adults, two votes) $20.00
□ Youth (non-voting) $
5.00
□ Please accept my additional donation to IHDA of $ ______________
Total Enclosed: $ _____________
Make check payable to: IHDA
and mail to: Steve Bean
3915 Pine Wood Dr. NE,
Cedar Rapids, IA
52402
E-mail: sbean9749@msn.com
(April 2008)