(C) 2006-2011 Pomeranian Club of Greater Baltimore Inc. All rights reserved.

Pomeranian Club of
Greater Baltimore, Inc.

Date________________________

Name_________________________________________________________ Birth Month/Day_________________________

Address_______________________________________________________________

City_____________________________________ State_____________ Zip___________________

Phone:___________________________ Cell____________________________ Email______________________________

Spouse / Person 2______________________________________________ Birth Month / Day_________________________
 Anniversary_____________________________________

Your status (check ALL that apply) Breeder______ Exhibitor______ Owner______ Handler______

Membership requested (check ONLY one) Individual ($20)______ Family ($25)______ Junior ($5)______

Number of Poms you owne now 1 5______ 6 -10______ 11-20 ______ over 20______

Poms Name________________________________ Registration No._________________________________________


__________________________________________ __________________________________________


__________________________________________ __________________________________________
 


Are you interested in Obedience Classes? Yes______ No______

Have you bred a litter of Poms in the past year? Yes______ No______

Have you exhibited any Poms in the past year? Yes______ No______

Do you own any other breeds? Yes______ No______ If YES, what kind(s)?____________



Do you belong to any other clubs? Yes______ No______ If YES, what club(s)?____________





Sponsors _________________________________________ Meetings Attended_____________________________________



Please mail with dues to

PCGB Membership Secretary Date Received ______________________
Barbara L. Bolstridge
38348 Millstone Drive Dues Pd $ ______________________
Purcellville, VA 20132
                             Date Approved______________________
Make checks payable to PCBG, Inc.

 Pomeranian Club of Greater Baltimore, Inc.