VBA Membership Application

VBA PO Box 480 Pisgah Forest, NC 28768

1. Name:________________________________

2. Address:_____________________________

3. Telephone & E-mail:_________________________________

4. Name of dogge or dogges registered:______________________________

5. Do you plan to attend any VBA Shows?____________________________

6. Are you willing to help at VBA Events?_____________________________

7. Would you be interested in the VBA Inspection Program?_______________

8. Would you be interested in helping with VBA dogge rescue?____________

9. Are you a breeder?_______________________

10. If you are a breeder how many breeds are you involved in?__________

11. How do you keep your dogges: Kennel, Chain, Inside Home?_____________

12. Are you involved with any other dog association?______________________

13. Will you participate in answering questions for newcomers on the VBA message board?________________________________________________

14. Would you report animal abuse to the authorities if you have knowledge of animal abuse in your area ?________

15. What is your view on dog fighting? _________________________________

______________________________________________________________________

16. Do you vaccinate your dogs regularly?_________

17. Do you use heartworm preventative?___________

18. Are you willing to show vaccination & worming records before entering your dogge into VBA events?____________________

19. Will you help to promote the VBA?___________________   

For any questions or comments please contact the VBA or the VBA Director [ Paula Zuniga ] . This is an application to become a member of the VBA, any information provided becomes the property of the VBA once this document is signed. The VBA has the right to cancel membership for falsification of any information above without refunding any fees that have been applie d.

Applicant Signature:_______________________________