Membership Renewal Form

First name

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Multi-line address

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Address

City

Zip / Postal code

Email

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Dog's Name

Breeds (s)

Print dogs names

Yes

No

Print Breed (s)

Yes

No

Jobs

Instructor

Board Member

Trial committee

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Other

Comments, questions, suggestions?

Individual

$20

Family

$25

Donation

$10

$20

$30

Pat Senne at

Sign up now before the classes fill up. Online registration & payment.

DuPage County Fairgrounds

2015 Manchester Rd

Wheaton, IL 60187

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