Kansas City Retriever Club--Membership Form

Kansas City Retriever Club Membership Form

The Kansas City Retriever Club is an organization devoted to conservation of waterfowl through the training and use of retrievers. Even if you do not own a dog, your membership is welcome as an expression of your interest in conservation.

Please print form to fill out

APPLICATION FOR MEMBERSHIP

Name:__________________________________________________________________________

Spouse:________________________________________________________________________

Address:_______________________________________________________________________

City:____________________________________________________________________________

State:______________________________ Zip Code:_________________________________

Home Phone:__________________________________________________________________

Business Phone:______________________________________________________________

E-Mail address:_______________________________________________________________

KCRC Sponsor:_______________________________________________________________

I enclosed the sum of $25.00 for my annual dues.

With a check made payable to KCRC.

Signed:_______________________________________________________________________

Date:_________________________________________________________________________

Mail with check to:

Joanne Wilbanks

111 E 114th Ter

Kansas City, MO 64114

816-442-7376