Please provide the following membership information:

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

What type of application is this?

  Choose one Renewal New Member

New members, please list two current members to be your sponsors

Household and regular memberships require residence in the Northeastern Illinois or Southeastern Wisconsin areas, and ownership of a Greater Swiss Mountain Dog.

Which membership are you applying for?

  Choose One Household $25.00 (two voting members) Regular $20.00 (one vote) Associate $15 (no vote)

How will you be paying?

  Choose one Paypal today (you will be directed there after this screen) Send a check today

In the last three years - have you (check all that apply)

Bred a litter of Greater Swiss Mountain Dogs?
Used a male GSMD as a Stud?
Bred a litter of any other dogs?
Used a male of any other breed as a Stud?

Would you please list the names of all of your Greater Swiss Mountain Dogs (if any) - both call and registered names

Would you be interested in serving on any of the following committees? (check as many as you are interested in)

Board of Directors            Officers                      Weight Pull                   Pack Dog                    
Awards                        Specialty Show Chair          Herding                       Newsletter Editor           
Newsletter article Columnist  Website                       Fun Day                       Carting                     
Ways and Means                AKC Liaison                   Club Photographer             

By submitting this application, you agree to abide by the constitution and by-laws of the Lake Shore Greater Swiss Mountain Dog Club, Inc., and the rules of the American Kennel Club.

Do you agree to these terms?

  Choose one Yes - I agree No - I do not agree