Membership/Subscription Application
The Golden Retriever Club of America, Inc.

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I hereby apply for membership in the Golden Retriever Club of America, Inc. I agree to abide by the Constitutions and Bylaws of GRCA and AKC, and further to promote the objectives of GRCA by (1) breeding Golden Retrievers that possess the soundness, temperament, natural ability and personality as reflected in the standard of the breed, and to do all possible to advance and promote the perfection of these qualities; (2) doing all in my power to protect and advance the interest of the breed through my sportsmanlike competition in all areas; (3) to follow the rules of AKC; and (4) to be guided by GRCA's Code of Ethics. I understand the subscription year is from January to December and that issues are not retroactive. All dues are on a calendar year basis, January to December. IF THIS APPLICATION IS ACCEPTED AFTER SEPTEMBER 15, NO DUES SHALL BE PAYABLE THE FOLLOWING YEAR.

For the United States:
( ) Single: $65 dues, subscription and application fee
( ) Family: $70 dues, subscription and application fee
( ) First Class Mailing of GRNews (optional): $25.00 additional  

For Canada and Mexico: (Includes First Class Mailing of GRNews)
( ) Single: $115.00 dues, subscription and application fee
( ) Family: $120.00 dues, subscription and application fee

All Other Countries:
(Includes First Class Mailing of GRNews)  
( ) Single: $215.00 dues, subscription and application fee
( ) Family : $220.00 dues, subscription and application fee
( ) GRNews subscription ONLY: $185.00 First Class mailing of GRNews included  

All countries (Optional) Membership Only:
( ) Single: $30.00 dues and application fee only. NO GRNews
( ) Family: $35.00 dues and application fee only. NO GRNews

____________________________________________________  _______________
Name   date
___________________________________________________
email
____________________________________________________________________   ___________________
Second applicant name (for family membership)   phone number
 
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Street and number   city and state   zip+4
 
 
________________________________  _________________________________
Applicant’s signature   Applicant's signature
 
Amount enclosed (or authorized to be charged to credit card): $ __________
 

Please mail completed form with fees to:
 

Deborah Ascher, Membership Administrator, P.O. Box 69, Berthoud, CO 80513-0069

Make checks payable to The Golden Retriever Club of America, Inc., or GRCA. For credit card payment, complete all information below. FOREIGN CURRENCY must be payable in U.S. Funds by BANK MONEY ORDER (not postal money order) in U.S. Dollars drawn on a U.S. Bank.

 ( ) Visa ( ) MasterCard 
 

____________________________________ card number

____/____/____ expiration date

______________ 3-Digit Security Code

_______________________________________
cardholder signature
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print cardholder name