Kennel or Family Membership (Two Votes)………………………$25.00

Single Membership (One Vote)…………………………..…………$20.00

NAME:_______________________________________________________________________________

ADDRESS:____________________________________________________________________________

CITY / STATE:___________________________________________________ZIP__________________

PHONE_________________________EMAIL ADDRESS______________________________________

Type of Membership: Kennel/Family_________Single_________Sub. Only___________

Please tell us a little bit about yourself, Family, and Dogs:

Your Primary interest in Australian Shepherds:

Conformation________Obedience__________Stockdog_________All Areas__________

Ranch/Kennel Name as registered with ASCA:_______________________________________________

Please tell us what you would like to see SWASA / Hindleg (newsletter) do or accomplish:

While your checking one of the following is not contingent on your being accepted for membership, we’re always looking for an "extra hand" – so please check any or all of the following if you think you could help out.

Host a workday at your place__________Ring Steward/Time Keeper at shows_______________________

Donate the use of stock for Trialing_________Sheep__________Cattle____________

Help handle stock___________________

I (we) hereby apply for Membership___________Renewal____________of Membership in the Southwest Working Australian Shepherd Association.

Signature:__________________________________Signature___________________________________