Name: ____________________________________

Address: __________________________________ __________________________________________

Occupation: ________________________________

Phone hm: __________________ wk: ___________________

E-mail: _____________________________________

Dogs you own: Please list AKC registered Name if AKC registered, give AKC Reg. number, Breed and any Titles earned.

1. _________________________________ ___________________________________

2. _________________________________ ___________________________________

3. _________________________________ ___________________________________

Have you bred an AKC registered litter in the last two years?   Yes   No    If yes, when? ___________ Number of Litters: _____ Breed: ______________

Have you run dogs owned by yourself in AKC hunt tests in the last two years?    Yes    No

Have you owned and/or handled a dog to an AKC Hunting Title?   Yes    No

Mark membership applying for:   Regular   Family   Junior

I agree to abide by ABDA's constitution and bylaws and the rules of the American Kennel Club.

___________________________________________ (Signature/date)

Please mail your completed application and a check for $25.00 Membership dues to:

ABDA attn: Treasurer
PO Box 90914 Anchorage AK 99509

Applications are voted on at the next membership meeting.