DOWN EAST HUNTING RETRIEVER CLUB
MEMBERSHIP APPLICATION
DATE: ______________________
NAME: ____________________________________________________________
ADDRESS: _________________________________________________________
_________________________________________________________
Check Number: _______ Amount:__________ Date:_______________
HOME PHONE NUMBER: ____________________________
CELL PHONE NUMBER: _________________________
EMAIL: ____________________________________________________________
DO YOU HAVE ACCESS TO THE INTERNET? YES _ NO _
DEHRC Secretary for 2012: John Stroud
Make checks payable to DEHRC and mail check and completed application to:
John Stroud at 598 Hardy Bridge Rd, Kinston NC, 28504
DEHRC dues: $30 per year for single membership or $50 per year for husband, wife and children under 18.