Colorado Australian Shepherd Association

Membership Application & Renewal

I am applying for a : (Check one)

_____Family Membership ( $15 Yr.) _____ Single Membership ( $10Yr.)

_____ Junior Membership ( $5 Yr.) ______ Half Year - Pay ½ Regular Fee

New Member ________ Renewal _________

PLEASE PRINT OR TYPE :

Name : ___________________________________________________________________________________

Address : _________________________________________________________________________________

City : ___________________________ State ________ Zip __________ Phone : ____________________

E-MAIL ADDRESS : ___________________________________________________

Kennel Name (if any) :______________________________________________________________________

My hobbies & special areas of interest are :_____________________________________________________

Areas in which I’d like to get involved with CASA club activities:__________________________________

My occupation is : _____________________________________________________________

Date of Application :______________ Amount Enclosed : ____________

_______________________________________ _________________________________________

Signature of Applicant Signature of Second Applicant

By signing this application, the applicant (s) agrees to adhere to the By-Laws of the

Colorado Australian Shepherd Association, Inc.

IMPORTANT : NEW MEMBERS ONLY !

This application must be signed by two (2) members in good standing with CASA.

_______________________________________________ _______________________________________________

Signature of First Sponsor Signature of Second Sponsor

MAIL THIS APPLICATION & YOUR CHECK , MADE PAYABLE TO CASA TO :

Connie Hull * 4525 S. 83^rd Avenue * Greeley, CO 80634

CASA meets every month at a regular meeting place. We’d love to have you there ! See our website at www.coloaussies.org for more information.

Check our web site for more info or call Connie at ( 970 ) 330 - 5341 or

Pat James, CASA President at ( 970) 847 -3759