Associate Membership

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First Name *

Last Name *

Email Address *

Street Address *

City

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ZIP / Postal Code

Mobile Phone *

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Facebook Email(Optional) Used for access to the WVCA Members Facebook page

The club may post members' names, emails, & phone numbers on a password protected, member's only website. Please select from the options below.

Occupation (optional)

Wirehaired Vizslas you own - Please list Call Name, Sex, DOB, Registered Name, and AKC or Foreign registration #. *

Please describe "other" dog-related interests not listed above.

I am currently:JudgeExhibitorBreeder

Are you interested/considering breeding in the future?

Kennel Name?

I am new to the breed and would like to learn more about:

Please share special skills you have that may help the club or other areas you would like to help that are unlisted above.

List current memberships in other (AKC) Parent or Local Breed clubs, Foreign Dog clubs, or Other (Hunt, agility, obedience, etc):

Have you ever been denied membership or been suspended by the American Kennel Club (AKC) or an AKC recognized Breed or All Breed Club? (If yes, please explain below.)

Rules for Applying for Membership -The membership period is for one year, from January-December. Dues shall be payable on or before the first of January of each year. On March first, an individual or family must re-apply for membership and submission to the board for consideration. For applications accepted October 1st through December 31st, membership and dues will be credited for the ensuing calendar year. Associate members are not voting club members. *Acknowledged

Associate Membership $20.00