To begin the membership process and be added to our email list, please fill out the form below and click the Submit button.Upon receipt of your submitted application form we will contact you with next steps and information about $30 payment for the annual dues. Membership application Type of Membership being applied for (select one): Individual Junior Associate Name First Last Name/s You Want On Your Club Nametag/s: First Last Occupation/s (Will not be included in directory) Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneMobile PhoneOffice PhoneEmail (If you would prefer any of the above information not be included in the directory, please note. Also please note which phone number you prefer in the directory.) Names of Westies/Ages/Breeders, if known: If within two hours’ drive of Atlanta:Date(s) that you attended the WHWTCGA meeting:If not within two hours' drive from Atlanta:Please tell us who you completed a phone interview with, and the date of the interview.Please complete the following: Names of Westies/Ages/Breeders, if known:We are interested in learning about: showing confirmation agility obedience earth dog training breeding healthcare grooming other Next year I am interested in assisting the Club by chairing or assisting with a committee (No experience required for any and many volunteers needed for most!); Ways & Means (fundraising) Programs Programs Hospitality Annual Banquet Animal Legislature Education Annual Picnic Website Historian Specialty Show Show Hospitality Breeder Referral/Education Westie of the Year! I have read and agree to the Code of Ethics provided on this website.(Required) Yes, I have read and approve the Membership Code of Ethics Additional Comments:The information provided above will not be disseminated other than possibly to the national Club (WHWTC of America), other regional clubs and/or the AKC. 30854Δ