Cocker Spaniel Club of Western Pennsylvania, Inc.
344 Barrel Valley Road, Spring Church, PA 15686, (724) 478-3428,

Dues are payable within 30 days of notification of membership. (see bottom of page for application procedure)

Individual ..........$15.00/year ........ Adult member who enjoys all privileges of CSCWP, including voting and holding office
Associate............$15.00/year ........ For persons living well away from the area served by CSCWP who are entitled to all club privileges except voting and holding office.
Junior ................$10.00/year ........ Open to persons 17 years old and under.  Such members are entitled to all club privileges except voting and holding office.
Family ...............$20.00/year ........ Family members living within the same household. All family members over 18 years old may vote and hold office

Name: _________________________________________________________________________________________
Address: _______________________________________________________________________________________
Phone Number: __________________________________ E-mail Address: _________________________________

Occupation, Hobbies, Expertise: ____________________________________________________________________________________ ________________________________________________________________________________________________________________
How long have you been a Cocker Spaniel owner? _______________________________________________________________________

Names of organizations you are or have been associated with and any offices held in them:______________________________________
Do you groom your own Cocker Spaniel?       YES or NO            
Would you like to learn to groom Cocker Spaniels?       YES or NO 
Do you  breed  or have you ever bred Cocker Spaniels? YES or NO    If so, explain your experience. ______________________________ _________________________________________________________________________________________________________________

How many years experience do you have in the following canine competitions?        
Conformation ____ Obedience _____ Rally _____ Agility _____ Hunting _____ Flyball _____ Tracking _____ Other __________________

Would you like help training in any of these area?  Specify:  _______________________________________________________________ _________________________________________________________________________________________________________________
Are you in good standing with the American Kennel Club?   YES or NO     If no, under what circumstances? ________________________ _________________________________________________________________________________________________________________

As a member in good standing with CSCWP, I agree that I shall not breed Cocker Spaniels for resale to stores or other retail outlets.  I will promote the spay/neuter of pet puppies. I acknowledge that I will read the By-Laws and will abide by the Code of Ethics of the CSCWP.  If I do not abide by the Code of Ethics, the Board of Directors may revoke my membership at any time.

1) Application requires signatures of 2 sponsor CSCWP members in good standing , not of same household. 2) Present application in person at club meeting held the third Tuesday of every month at 7:00 PM. Call 724-478-3428 for current location  Application may be mailed if distance to meeting exceeds 50 miles.  3)Application to be read two times and published one time in club newsletter.  Any comments, concerns or objections regarding and applicant must be submitted in writing to Membership Chairman 7 days prior to voting meeting.  4) Vote by secret ballot at second meeting following receipt of application.  5) Notification by mail of acceptance or denial.  6) Dues to be paid within 30 days of notification.

I agree that all information given in this application is accurate and complete.

Applicant Signature: ___________________________________________________________   Date: ______________________________

Signatures of two (2) sponsors in good standing with CSCWP: 1)___________________________________________________________

MAIL APPLICATION TO SECRETARY:   Joan Kunkle, 344 Barrel Valley Road, Spring Church, PA 15686