
THE JACK RUSSELL TERRIER CLUB OF AUSTRALIA INC.
(Developers of the Breed in Australia)
APPLICATION FOR MEMBERSHIP/RENEWAL
OF MEMBERSHIP - 2006/2007
A Membership Receipt (which should be kept as proof of membership) will be sent out upon approval of membership. Cheques or Money Orders (No cash in mail please) (overseas payments to be in Australian Dollars please) should be made payable to the Jack Russell Terrier Club of Australia Inc. and mailed to:-
“The Membership Secretary” 61 Somerville Lane, Riddells Creek, 3431
Mr/Mrs/Miss/Ms,__________________________________________________________________
________________________________________________________________________________
Telephone Number: ( )______________________________Post Code:____________________
I/We wish to become a member of THE JACK RUSSELL TERRIER CLUB OF AUSTRALIA INC.
If I/we are admitted as a member, I/We agree to be bound by the Club statement of purposes, rules and regulations and will at all times adhere to club guidelines and policy. For the purposes of club publications where my name, address and telephone number may be required I hereby DO/DO NOT give permission for it to be used. Please delete.
Signature Of Applicant:___________________________________________Date:______________
Prefix:____________________________________________M/Ship No:______________________
The Annual Subscription of $35.00 (for individuals or family) or $45.00 (for overseas members)
is due on the 1st of March each year and is current until the 28th Feb of the following year.
Please Note: A reduced membership of $25.00 per year.
This reduced rate applies only to family members living in the same household as a person holding a full membership of the club. This membership does not include a copy of the club magazine but does entitle the holder to full voting rights and all other rights pertaining to membership of this association.
New Members who join after the 31st August of any year $20.00 ($30.00 overseas) subscription applies, (with the normal subscription rate due March 1st of the following year). NB: This reduced fee applies to New Members only and not to Renewals.
Please note children under the age of 18 years must be accompanied by an adult on this membership form, as documents may need to be signed, i.e. Service Certificates, Litter Returns etc.
ANNUAL RETURN
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Please list additional Dogs/Bitches over the page. REG. NO: A0007801Z