POTOMAC HOUND CLUB Membership Application (page 1) Name :______________________________________________Occupation:_________________________ Address :_________________________________________________________________________________ Phone Number(s):________________________________________________________________________ Email Address :_____________________________________________FAX Number:________________ Breed :___________________________________Years in the Sport of Purebred Dogs:____________ Interest(s):_______________________________________________________________________________ Current Activity in Dogs (e.g., breeder, exhibitor, handler, judge):__________________________ __________________________________________________________________________________________ List other dog clubs (including parent clubs) in which you are/were a member, the dates, and offices/positions held: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Briefly describe your activities and accomplishments in the sport of purebred dogs: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________
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