The Bernese Mountain Dog Club of Ireland
Application for Membership
The BMD Club of Ireland exists to promote, advance and protect the interests of the breed. The Club will welcome as members those who have the same interests as heart.
Please answer the following questions as fully as possible and add any other relevant information at the end of the form.
Name in full: Mr/Mrs/Ms/Miss __________________________________________________
Affix: ____________________________________________________________________
Address: ____________________________________________________________________
Phone No. ____________________________________________________________________
Email: ____________________________________________________________________
Do you have/ have you had any Bernese? ____________________________________________
From whom and where did you get them? ____________________________________________
IKC Name of dog/bitch _______________________________ D.O.B. __________________
Name of sire _____________________________ Name of dam __________________________
Have you bred any Bernese? ________________________________________________________
What is your interest in the breed? Companion/Showing/Breeding/Other ____________________
Are you a member of any other BMD club? If so, please give details ____________________
________________________________________________________________________________
Do you have any other breeds? __________________________________________________
Name/Address of proposer and seconder (must be fully paid up members)
Proposer’s name ______________________________________________________________
Proposer’s address ______________________________________________________________
Seconder’s name ______________________________________________________________
Seconder’s address ______________________________________________________________
Can you give the name/address of someone who would provide a reference for you, e.g. a vet or someone already in the breed?
Name: ___________________________ Telephone: __________________________
Address: ____________________________________________________________________
Type of Subscription:
Single (1 person) €12 or £10 _______________
Joint (2 partners) €15 or £13 _______________
Family* (eg. Mother, father and 3 children = 5) €15 or £13 _______________
GB & Europe (except NI) €18 or £16 _______________
Overseas (US, Canada, Australia) €20 _______________
Membership runs from 1st October to 30th September. Please note that family memberships must give the number in the family (parent(s) and minor children). Please indicate the category clearly. Subscriptions MUST accompany application. Cheques should be made payable to Bernese Mountain Dog Club of Ireland. A copy of the Rules and Regulations of the BMD Club of Ireland and the Code of Ethics of the I.K.C. are available on the website (www.berneseireland.com). Please read them carefully, print them and retain them. Please ensure that you sign the DECLARATION on the application form and return the completed form along with your subscription to the Secretary. Your application will be raised at the next committee meeting and you will be notified as soon as possible thereafter.
DECLARATION: I/We am/are fully aware of the Rules and Regulations of the BMD Club of Ireland and of the Code of Ethics of the Irish Kennel Club and I/we am/are prepared to abide by them.
Signature/s of applicant/s __________________________________________
__________________________________________
Date: __________________________________________
Return to: The Secretary
Valerie Hughes,
Berner House,
Russelstown,
Milltown,
Co. Galway
Telephone: 093 51861
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