PUGET SOUND PUG DOG CLUB INC
MEMBERSHIP APPLICATION
I (We), ___________________________________________________________________________, do hereby
make application for membership in the Puget Sound Pug Dog Club Inc. I (We) understand that I (We) must be
sponsored by two members in good standing before I (We) can be considered for acceptance. In making application
I (We) wish to apply as follows:
______$10.00 Individual ______$15.00 Couple ______$7.50 Each Additional Household Member
______$10.00 Out of Area
Residence Address___________________________________________________________________
City________________________________________State_________ ZipCode___________-_______
Phone1(________ )__________-______________ Phone2 (________)__________-_____________
Fax(______)________-___________ Email______________________________________________
Website Address____________________________________________
(Please Circle and/or Complete the Following)
Do you currently own a Pug(s)? Y / N Have you owned Pug(s) in the past? Y / N For how many years?
Is your Pug(s) American Kennel Club (AKC) registered? Y / N Are you in good standing with the AKC? Y / N
Do you exhibit your Pug(s) in: Conformation Obedience Agility Therapy Other _______________________
Do you have AKC Titles on any of your Pug(s)? Y / N Which? ___________________________________________
Do you believe in breeding Pugs of poor quality? Y / N or breeding Pugs not registered with the AKC? Y / N
Do you plan to use your Pugs in a breeding program? Y / N
What is your Kennel name? _________________________________
Why do you wish to join the Puget Sound Pug Dog Club Inc?______________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
What do you hope the Puget Sound Pug Dog Club Inc can do for you?______________________________________
_____________________________________________________________________________________________
__________________________________________________________________________________
On which committee(s) would you like to serve? Education Historian Hospitality Legislative Membership
Publicity Rescue Shows Stewarding Ways & Means Web Site Other _____________________________
I (We) have read and, if I (We) are granted membership, I (We) agree to abide by the Constitution, By-Laws, Code of
Ethics, and Regulations of the American Kennel Club, The Pug Dog Club of America and the Puget Sound Pug Dog
Club. I (We) will do all in my(our) power to protect the Pug breed, to bring its natural qualities to perfection and to
support others who agree with this goal.
Signature1___________________________________________________Date___________________
Signature2___________________________________________________Date___________________
Sponsor1____________________________________________________
Sponsor2____________________________________________________
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(This section for club use)
Application Received Date ______________________________
Club Voted Date ______________________________
Applicant(s): Accepted? Rejected?
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Please print and send your completed and signed application with appropriate fees to:
Puget Sound Pug Dog Club Inc, Secretary
Carolyn M. Brugge
2117 SW 156th St.
Burien WA 98166
We will review all completed applications at the next regularly scheduled club meeting.