Airedale Terrier Club of Illinois
Application for Membership - 2022

• 1.  Fill in application below

• 2.  Attach sire and dam for each Airedale that you own or co-own, including the names of the breeders, if available.

• 3.  Submit application along with a check for $20.00 to the Club Secretary or bring completed application to a club meeting.

First Name:  ___________________________________   Last Name:  _________________________________________________________

Address:  ____________________________________________________________________________________________________________

City:  ______________________________________________________________  State:  _____________________  Zip:  ________________

 Home Phone:  (          ) ______________________________________  Cell Phone:  (          ) ________________________________________

 Email:  _______________________________________________________________________________________________________________

 List any dog club affiliations: ___________________________________________________________________________________________

______________________________________________________________________________________________________________________

Do you breed Airedales?  (Y/N) _____________     Kennel Name: ____________________________________________________________
Are you an exhibitor of Airedales?  (Y/N) ______________  If Yes, are you involved with:  (Y/N)
Conformation ___________  Obedience _______________  Agility _____________  Rally  ______________ Barn Hunt ________________

Other  ________________________________________________________________________________________________________________
The ATCI is involved in activities over the course of the year.  We hope that you will be able to give of your time and skill and assist the Club in one of these activities.
Please indicate areas of interest:
June Specialty ________________  Meet the Breed _____________  Club Member Events ________________ 

Other skills the Club might find of assistance ______________________________________________________________________________

Please contact the Club Secretary if you have further questions.  ATCI is looking forward to meeting you and your Airedale(s)!

I am interested in the Airedale Terrier and I subscribe to the Club's objectives to promote the best interests of the breed.

Signature: _______________________________________________________________  Date: ____________________________