Membership Renewal

Family $40.00

Dual $30.00

Single $25.00

Junior $10.00

Payment is to be made by Direct Deposit to -

Account Name The Dobermann Club of NSW
BSB 062 000
Account 009 219 84

Commonwealth Bank

Reference Please include your full name.

All members are required to read and agree to -

I/we wish to apply for membership renewal of The Dobermann Club of NSW Inc.

Name

First Name

Last Name

Phone

(###)

###

####

Email

Membership Level

Name(s) of Other Related Members

If you have selected a Family or Dual membership level, please provide the full names of other people who will be a part of this membership

Have you made payment?

Yes

No

I/we have read and agree to be bound by the Code Of Ethics and to at all times obey the Constitution, of The Dobermann Club of NSW inc.?

Yes

No