Your Name(s) :

Mailing Address :

City / Town

Province / State

Postal / Zip Code

Country

Main Telephone # : 

Day      Evening    Anytime

2nd Telephone # : 

Day      Evening    Anytime

E-mail Address :

Fax # : 

Are you a new member ?

No      Yes

Are you a member of the Canadian Kennel Club ?

No      Yes   CKC #

Are you a member of other dog clubs ?

No      Yes

    If Yes, please specify which clubs :  

What is your availability for attending LCO Events & Meetings :

Saturdays               Sundays                Either Day

I/We hereby apply for membership in the Leonberger Club of Ontario and do certify that I/we are eligible for membership or are presently members in good standing of the Canadian Kennel Club.

I/We have never been found guilty of an offense by any humane society.  I/We hereby agree to abide by the By-Laws and Code of Ethics of the Leonberger Club of Ontario. 

Please type in your initials to act as a

signature for agreeing with the above statement

Today's Date

(as of January 1, 2013)

Single Membership

Family Membershp

International  ( Outside North America )

Comments :  please add additional information here, if required.

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        by a loving and caring human interested in becoming a member of the LCO.

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October 15, 2019

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