| Mid - Atlantic Basenji Club |
Everyone interested in Basenjis is welcome! You may print this application and mail it with your dues to:
Iris Craven
MABC, Inc. Membership Chairman
2332 Gillis Road,
Mt. Airy, Md. 21771-8703
Phone 410-875-2449 if you have questions.
Membership Application
annual dues form with membership profile
Mid - Atlantic Basenji Club, Inc.
1 Year Membership:
_____ Family $10.00 _____ Single $7.00 [ ] membership application [ ] annual dues renewal
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The questions below are optional; but we would greatly appreciate it if you would take a few extra minutes to let us know what your interests are so that the Club may respond to those interested in its programs and newsletter articles. Thanks!
Would you be interested in being listed in a BREEDERS DIRECTORY? If so please give
Name of KENNEL and (P) PUPPIES, (S) STUD SERVICE and/or (A) ADULTS.
How long have you had a Basenji? _______
Primary areas of interest (or activities in which you participate with your Basenji(s)):
active in interested in
Pets/Companion [ ] [ ]
Conformation [ ] [ ]
Lure Coursing [ ] [ ]
Obedience [ ] [ ]
Tracking [ ] [ ]
Agility [ ] [ ]
Jr. Showmanship [ ] [ ]
Other _____________________________________ [ ] [ ]
On what topics would you like to see newsletter articles or club programs? Learn more about?
[ ] General information on dog shows [ ] dog photography
{ } health/veterinary care [ ] lure coursing
[ ] agility [ ] obedience training
[ ] conformation standards [ ] breed history
[ ] behavioral problems [ ] breeding and whelping
[ ] puppy rearing methods [ ] community service activities
[ ] grooming [ ] show handling
[ ] animal products [ ] rescue work
[ ] other (suggestions are greatly appreciated)
In what Club activities would you consider participating? Check those of interest; checking any of those
areas will not obligate you to serving on the Committees.
[ ] rescue: temporary home (pick-up)
[ ] rescue: foster home (adjustment period)
[ ] hospitality/coordinating club functions
[ ] club officer
[ ] publicity
[ ] obedience
[ ] fun match
[ ] canine learning experiences (ideas and/or manning a booth)
[ ] sunshine committee
[ ] work at asfa / field trials
[ ] newsletter
What goals do you think the Club should have?
Suggestions for improvement and/or additional activities
Thank you for taking time to fill out the questionnaire!