Name: __________________________________________
Street Address: ___________________________________
City: ___________________ State: ______ Zip: ______________
Phone Number:______________Fax:_______________________
(Please Include Area Code)
E-Mail Address: __________________________________________
(To be added to email newsletter list)
Please Check One:
New Member: __________ Renewal__________
Amount Enclosed: __________( $35.00 Yearly Dues)
The membership runs from July 1st to June 30th. Dues are $35.00 a year.
Please make checks payable to Carolina Boykin Spaniel Retriever Club (CBSRC)
Dues may be sent to the following address:
CBSRC Secretary
Dawn Crites
1274 Langford Road
Blythewood, SC 29016
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