Street Address: ________________________________________________________________________
City / State / Zip: _______________________________________________________________________
Phone Number: _______________________ E-mail Address ____________________________________
Kennel Name (if applicable): ______________________________________________________________
APPLICATION FOR: _____ Individual Membership ($15 annual dues)
_____ Each additional membership same household ( $5 each )
_____ Junior Membership (8-18 years of age) (no annual dues)
I / we own the following Briard(s): NOTE: Briard ownership is not required for membership.
Dog's registered name: _____________________________________________________________
Dog's call name: __________________________________________________________________
AKC or other titles: ________________________________________________________________
Date of birth: ________________________ Sex: _______ Color: ___________________________
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Dog's registered name: ____________________________________________________________
Dog's Call name: _________________________________________________________________
AKC or other titles: _______________________________________________________________
Date of birth: ________________________ Sex: ________ Color: __________________________
(* If more space is needed to list your Briards please use additional sheet or back of application form.)
Have you owned a Briard before ? _____ YES _____ NO
If yes, dog's name: _______________________________________________________
Circle the dog related activities that interest you the most:
Conformation Obedience Other: (explain) ______________________
Herding Agility ___________________________________
Education Health ___________________________________
In what ways would you like to get involved with the Club ? ____________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
I / we agree to abide by the Constitution and By Laws of the Michigan-Ohio Briard Club, and the rules of
the American Kennel Club. Dues for the current year are enclosed with this application.
Date: __________________ Signature(s): _______________________________________________
_______________________________________________
When completed, mail your application with check payable to the Michigan-Ohio Briard Club, to:
Maureen Moreau, Membership Chair
Michigan-Ohio Briard Club
35514 Eastmont Drive
Sterling Heights, MI. 48312
Phone: (586) 978-1708
E-mail: maureenmoreau87@hotmail.com