HRC, INC. - MEMBERSHIP APPLICATION
| Individual (USA) | Individual (Foreign) | Family (USA) | Family (Foreign) |
| 1 yr. $25 / 2 yr. $50 | 1 yr. $30 / 2 yr. $60 | 1 yr. $30 / 2 yr. $60 | 1 yr. $35 / 2 yr. $70 |
Please charge a 1 yr ____ 2 yr ____ membership to my
VISA or MC #__________________________________________________ Amt.: _________________
Signature: ______________________________________________ Exp. Date __________________
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NAME:_____________________________________________________________________
OTHER FAMILY MEMBERS:___________________________________________________
ADDRESS:_________________________________________________________________
CITY:________________________ STATE: _____ ZIP: __________ COUNTRY_________
Home (____) _______________ Work (___) ______________ E-Mail_________________
ARE YOU A MEMBER OF ANY RETRIEVER CLUB? NO ______ YES ________
(If yes, Name___________________________________________________________)
WOULD YOU BE INTERESTED IN FORMING AN HRC SANCTIONED CLUB IN YOUR AREA? _____
Call (269) 343-9020 and charge your membership to your credit card OR print & and Fax to (269) 343-7037 or return this application and your check made payable to HRC (U. S. Funds only) to:
HUNTING RETRIEVER CLUB, INC.
MEMBERSHIP DEPARTMENT
100 EAST KILGORE ROAD, KALAMAZOO, MI 49002-5584