The Chihuahua Club of America Membership Application

CCA Membership Committee Chair: Sherrie Shirky

6410 Falls Church St., San Antonio, TX 78247

sshirky52@gmail.com

Please read & answer all questions. Your application may be denied if incomplete.

First name

Last name

Address:

Country/Region

Address

City

Zip / Postal code

Phone

Kennel Name:

Are you a member of a local or regional Chihuahua Club?

Yes

List all dog club affiliations (all breed, specialty, obedience clubs and positions you have held):

Have you or any member of your household ever been suspended by the AKC, comparable foreign organizations or other dog clubs?

Yes

If yes, please explain:

How long and in what capacity have you been involved in purebred dogs?

What particular interest and/or abilities would you like to contribute to the Chihuahua Club of America?

What other breed(s) do you own now or have owed in the past?

How many dogs currently live on your property?

How many dogs do you co-own?

How many Chihuahuas do you own at this time?

Please provide the name and address of the person from whom you obtained your last Chihuahua (other than your own breeding)?

How many litters of Chihuahuas have you bred in the last five years?

Have you earned an AKC championship or obedience title on dogs owned by you (Chihuahuas or other breeds)?

Why do you want to join the CCA?

Are you willing to have a home visit by a CCA appointed representative?

Yes

If no, please explain why in detail:

Do you belong to PETA?

Yes

Do you belong to HSUS?

Yes

Have you ever transferred a puppy or dog to a retail outlet for placement?

Yes

Applicants must be sponsored by two members of the CCA in good standing. Fill in the sponsor's names below along with their email address...sponsors cannot be from the same household and must have known them for one year. Sponsors will be emailed a form to be completed.

Sponsor #1 name:

Sponsor #1 email:

Sponsor #2 name:

Sponsor #2 email:

If your application contains false information, you will be removed from membership. Application fees are non refundable.

New Membership Application Fees

$45

I certify that I am 18 years of age or older.

If accepted, I will follow the Constitution and By-laws of the Chihuahua Club of America, comply with the Code of Ethics and abide by all decisions of the Board of Directors in disciplinary matters. I understand that the objectives of the CCA are to encourage and promote quality in the breeding of purebred Chihuahuas.

Today's Date:

Membership Application Signiture:

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