UBPA Membership Application
Name: *
Your answer
Address: *
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Phone: *
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E-mail: *
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Type of membership *
All memberships renewable annually
Method of Payment *
Mail checks or money orders to the Treasurer: attention Rick Donohue, 17530 Willis V. McCall Rd., Umatilla, FL 32784
Berger Picard dogs you own: *
Please include name (registered and call), date of birth, sex, UKC registration number (and any additional registrations--AKC, FCI, CKC, etc.), Sire, Dam, and Kennel (if not included in dog's name).
Your answer
Are you willing to submit all dog registration information to the UBPA for our database? *
How did you hear about our club? *
Your answer
Please list any Club Member references: *
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Do you belong to any other breed clubs? *
If yes, which ones?
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Do you plan to show/trial or currently show/trial your Berger Picard(s) in any licensed dog breed registry events? *
If yes, which events?
Do any of your Berger Picards currently hold UKC titles? *
Required
Number of dogs with titles in each event
Your answer
Do you have experience participating in showing/trialing with other breeds? *
If yes, what breed(s) and events?
Your answer
Do you plan on becoming a breeder (or are you already a breeder) of Berger Picards?
Do you have any experience as a breeder of other breeds of dogs? *
If yes, what breed(s)?
Your answer
Please list any activities or positions you are interested in and would be willing to volunteer for. *
Your answer
Would you like your dog(s) included in our membership directory?
I have read and agree to the Code of Ethics of the United Berger Picard Alliance *
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