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Junior Membership Application for the STCA (PDF Version: 184KB / 1 page)   SCOTTISH TERRIER CLUB OF AMERICA APPLICATION FOR JUNIOR MEMBERSHIP Junior Members, 10 to 17 years of age NAME: ______________________________________________________ ADDRESS: ___________________________________________________ __________________________________________________________ Telephone: _____________________ E-MAIL: ________________________ BIRTH DATE: ___________________________ A Junior Member will be eligible to convert his/her membership to full membership at the dues cycle following the 18th birthday. PARENT/GUARDIAN NAME ___________________________________________ PARENT/GUARDIAN ADDRESS________________________________________ ____________________________________________________________________ JUNIOR APPLICANT’S INVOLVEMENT WITH SCOTTISH TERRIERS: ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ JUNIOR APPLICANT’S INVOLVEMENT IN SCHOOL AND COMMUNITY ACTIVITIES: ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ SPONSOR #1_______________________________________________________ Address___________________________________________________________ SPONSOR #2_______________________________________________________ Address___________________________________________________________ Please Initial the following: ____ I have read, signed and sent a copy of the STCA Code of Ethics with this application. ____ I have included the application fee and first year’s dues fee of $45.00 with this application. ____ I have notified my sponsors requesting the sponsor’s form be sent to the Membership Chairperson. ______________________________________________ ___________________ Signature of applicant                                                           Date (Do not write in this space) Date application received: ____/____/________ Amount of check $_________ Sponsors Approved (1) ______ (2) ______ Code of Ethics signed ______ Date of Acknowledgment ____/____/________ Board Action ______ Membership Date ____/____/________ Back to Membership      Back to Who Are WE?