Online Membership Form - Golden Retriever Club of Canada

Online Membership Form

Instructions

INSTRUCTIONS:

Each person applying for a Single, Joint Household, or Junior Membership must complete the Membership Application and submit the form individually.
ALL fields marked * ARE REQUIRED
Click the Submit button to send in your data
Once you have submitted all the membership information, you will be directed to a separate page to complete your payment online (e-transfer or credit card).

PLEASE NOTE: Your electronic form acceptance is not finalized until we receive your payment. Online submissions will be CANCELLED if your online payment is not received.

I/we agree to abide by the Constitution and Bylaws of the Club and to honour its Code of Ethics.

Type of Application: *

New

Renewal

Referral

Type of Membership: *

Single ($35.00)

Joint Membership ($40.00 - 2 people same household)

Single Membership + Junior Membership ($35 single + $2.50 junior - Ages 8 - 15)

Joint Membership + Junior Membership ($40 - 2 people same household + $2.50 junior - Ages 8 - 15)

Type of Referral Membership: *

Single

Joint Membership

Single Membership + Junior Membership

Joint Membership + Junior Membership

Last Name: *

First Name: *

Email: *

Joint Member Last Name: *

Joint Member First Name: *

Joint Member Email: *

Junior Member Last Name: *

Junior Member First Name: *

Junior Member Age: *

Address: *

Country

City

State

Zip code

Phone: *

Kennel Name:

Tattoo Combination:

Payment *

Are you paying by:

E-transfer (auto-deposit no password required)

Credit Card

Cheque

Name of Referrer: *

e-Signature (selecting Yes indicates that you agree to abide by the GRCC membership requirements and agree to pay the required fees electronically): *

Yes

Referral Memberships:

Upon hitting submit you will be taken to a payment processing page. Please do not submit payment. Once your referral membership application is processed, the membership secretary will be in contact with you.