Name Date
Address
City State Zip Phone
E-Mail Address Kennel Name
Occupation
Interest & hobbies other than dogs:
How many Papillons do you own? Males Females
Other breeds owned:
Primary interest: ¤ Breeding ¤ Obedience ¤ Conformation ¤ Pet
Other dog organizations you belong to or have belonged to:
What can you do for M.A.P.:
What do you expect M.A.P. to do for you?
¤ I wish to receive the MONARCH newsletter on line (http://mapnews.net). ¤ I wish to receive the MONARCH newsletter in hard copy
The applicant agrees to abide by the club constitution and by-laws and the rules and by-laws of The American Kennel Club.
Check all that apply:
_____$20.00 for first family member (regular or associate) _____$ 5.00 for each additional family member
_____ $8.00 for Breeders' List ____$ 4.00 Junior Member (under 18 yrs of age)
Applicant signature First sponsor (Club Member)Amount enclosed
Second sponsor (Club Member) Return Check with application to:
340 Broadview Lane, Annapolis, MD 21401
FOR TREASURER'S USE ONLY
Date Amount
Paid by Check # Money Order Cash