Garden State Australian Shepherd Association

Membership Application/Renewal

Australian Shepherds are the most exciting dog breed in America today!  Hardworking, smart and beautiful, the versatile Aussie is a dog to behold. Pick from black, red, or blue there’s a variety for everyone. Aussies are not for everyone, but if they are for you, join us to celebrate this wonderful breed by becoming a member of GSASA.

Date:___/___/___

Name(s):________________________________________________________________

Address:________________________________________________________________

City, State and Zip:________________________________________________________

Telephone:­­__(____)_________________ e-mail:_______________________________

ASCA Membership # (if you are a member of ASCA):____________________________

Number of dogs:_______________

I am interested in the following (check as many as apply):
GSASA Newsletter via e-Mail (  )
Conformation (  )
Obedience (  )
Agility (  )
Working Stock (  )
Tracking (  )
Other (  )

I (we) the undersigned do agree to abide by the Constitution, By-laws, Registry Rules, Regulations, all Program Rules, Code of Ethics, and Dispute Resolution Rules of both ASCA and GSASA.

Signature #1:______________________________

Signature #2:______________________________

Annual Dues: $15.00
Family $20.00

Note: anyone accepted into GSASA after the last day of June, need only Pay half the amount for the remainder of the year.

Please send dues (checks payable to GSASA) to:
Laurie Shuren
PO BOX 273
Stanhope NJ 07804

For office use only:
Date received:____/____/_____
Amount received____________
Check#_________