DEL BAY RETRIEVER CLUB, INC.

Name: __________________________________________________________________________
Kennel Name: ____________________________________________________________________
Address: ________________________________________________________________________
City, State: ____________________________________________________ Zip Code: __________
Home phone: ___________________________________ Business phone: _____________________
Fax: ______________________________
Email address: ____________________________________________________________________
WWW home page URL: ____________________________________________________________
Number of years involved with retrievers: ____________ Breed: ______________________________

Participate in: (please place an "X" next to all events in which you participate)
AKC Field Trials____ AKC Hunt Tests____ AKC Obedience Trials____ AKC Agility Trials____
AKC Conformation Shows____ AKC Tracking Tests____ NAHRA____
OTHER (please list) _______________________________________________________________

Professional trainer _____ Amateur _____

Titles or placements you have obtained with your retrievers: (please place an "X" next to all that apply)
AKC Field Trials: FC___ AFC____ NFC____ NAFC____ placed/JAM in Open____ placed/JAM in Amateur____ placed/JAM in Qualifying____ placed/JAM in Derby____ Qualified All Age____ Derby List____

AKC Hunt Tests: Master Hunter ____ Master National Qualifier____ Senior Hunter____ Junior Hunter____
Working Certificate____ Working Certificate Excellent____

AKC Obedience Trials: CD____ CDX____ UD____ UDX____ OTCH____ CGC____

AKC Tracking Tests: TD____ TDX____

Other: ___________________________________________________________________________

Judging experience: (please place an "X" next to all that apply to your judging experience)
AKC Field Trials: Total # of Pts: _______ Open____ Amateur____ Qualifying____ Derby____ Puppy_____
AKC Hunt Tests: Total # of Pts: _______ Master Hunter____ Senior Hunter____ Junior Hunter____ Puppy_____
AKC Obedience Trials: Novice____ Open____ Utility____ CGC____ AKC Tracking Tests: TD____ TDX____
Other: _______________________________________________________________________________

Volunteer: (please place an "X" next to all categories in which you would be willing to help)
AKC Field Trials: Judge____ Marshaling____ Flyer Gun____ Popper Gun____ Throwing____ Blind Planting____
Lunch Planner____ Chairperson____ Event Secretary____ Field Trial Committee____

AKC Hunt Tests: Judge____ Marshaling____ Flyer Gun____ Popper Gun____ Throwing____ Blind Planting____
Lunch Planner____ Chairperson____ Event Secretary____ Hunt Test Committee____

Other: Picnic Trials____ Training Days____ Basic Obedience Days____ Newsletter____ K9 Eye Clinic____
Clean Up Day on the Canal____ AKC Judges’ Seminar____ Company Store____ Committee member____ Hospitality____ Other: (please list) ______________________________________________________

I hereby agree to abide by the Constitution and By-Laws of the Del Bay Retriever Club, Inc. and the governing rules of the American Kennel Club.

_______________________________________________________________________________________
APPLICANT'S SIGNATURE & Date

DBRC Membership Sponsors: (Must be a current good standing DBRC member)
____________________________________________________
#1 - Member's name
____________________________________________________
#2 - Member's name

Membership dues are $20.00 per person per year. Please remit check or money order along with a separate application for each individual. Thank you for your interest in Del Bay Retriever Club. Your application will be presented at the next meeting of the DBRC Board of Directors and Officers. You will be notified of the Board of Directors' and Officers' decision regarding your application for membership.
Please return this application to : Lois Gebrian, DBRC Secretary, 708 Walker School Road, Townsend, DE 19734, telephone 302-750-0025, This e-mail address is being protected from spambots. You need JavaScript enabled to view it