Membership categories (see sidebar for membership descriptions):

Single Membership - $30 annually
Family Membership - $40 annually
Breeder/Stud Single Membership - $40 annually
Breeder/Stud Family Membership - $50 annually

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Name:

Address:

City: State: ZIP: Country

Home Phone: Cell Phone:

Email:

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List Family Members and their relationship to you [for Family Memberships only]

Family Member 1:

Family Member 2:

Family Member 3:

Family Member 4:

Family Member 5:

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Are you a member

of any other dog club(s)? If so, please list which clubs and whether or not you hold any positons in that club.

How did you hear about the ISSDC? What attracted you to the ISSDC?

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Please list both the registered and call name of your Shiloh Shepherds.
If you have more than five (5) Shilohs, please submit additional names under the comments section.

Registered Name: Call Name:

Registered Name: Call Name:

Registered Name: Call Name:

Registered Name: Call Name:

Registered Name: Call Name:

What is your Shiloh Shepherd Kennel name (if applicable):

What is your website address (if applicable):

Do you have breedable or potentially breedable Shiloh Shepherd adults or puppies? yes no

If so, may we contact you about listing your dog(s) on our club website? yes no

May we list your name on our public membership roster? yes no

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The following responsibilities are vital to the continuation of the ISSDC. Please select the area(s) of interest to you and your family members and tells how you can help:

Administration
Rescue/Foster
Fund Raising
Genetics/Research
Record Keeping
Newsletter Publishing
Newletter Articles/Stories
Graphic Arts/Design
Help with Web Presence
Hosting an Event
Volunteer at Events
Other (please list)

What types of events/functions would you like to see the ISSDC run? (please check all that apply)

Breed Ring	I would be willing to host or spearhead this type of event I would just like to participate
Obedience	I would be willing to host or spearhead this type of event I would just like to participate
Carting	I would be willing to host or spearhead this type of event I would just like to participate
Therapy	I would be willing to host or spearhead this type of event I would just like to participate
Herding	I would be willing to host or spearhead this type of event I would just like to participate
Search & Rescue (SAR)	I would be willing to host or spearhead this type of event I would just like to participate
Fun Days (games/picnics)	I would be willing to host or spearhead this type of event I would just like to participate
Educational Seminars	I would be willing to host or spearhead this type of event I would just like to participate
Health Clinics	I would be willing to host or spearhead this type of event I would just like to participate
Other (please list)

Additional comments:

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SELECT PAYMENT OPTION:
	On Line Payment
	Regular Mail Payment, I agree that my membership will be suspended in the event payment is not received in a timely manner.
	I agree to abide by the Constitution and Bylaws of the ISSDC, Inc.