| SCOTTISH TERRIER CLUB OF
AMERICA |
| HONORARY MEMBERSHIP
NOMINATION |
|
| NAME
___________________________________________________________ |
| ADDRESS_________________________________________________________ |
| STCA MEMBER: (YES) (NO) MEMBERSHIP SINCE
_____________________ |
STCA INVOLVEMENT (examples: involvement in
committees, offices held, Bagpiper, website, publications, presentations, etc)
_________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________
|
INVOLVEMENT WITH SCOTTISH TERRIERS
(examples: involvement as a breeder, exhibitor, judge, instructor, rescue
worker,
etc)_________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________
|
OTHER INFORMATION (examples: why this
person should be granted Honorary Membership. This is particularly important
for the non - member applicant)
_________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________
|
| Name of
Sponsor__________________________________ Date_____________ |
| Address__________________________________________________________ |
| Phone: _________________________
E-Mail:____________________________ |
|
|
| Complete this form and mail to the STCA
Membership Chairperson Liz Heywood, 30 Starbarrack Rd., Red Hook, NY
12571-2249. |
|