Please send completed form to: Maurice Hill 430 E. Broadway Crystal Lake IL 60014 Any questions please contact: Pam Hughes 198 Bates Rd. White Salmon, WA 98672-8504
			The United States Lancashire Heeler Club Membership Form
Many narrative essays online we worked on are available for our clients once this form is filled in and approved.
		Name:__________________________________Address:_______________________________________________ _____________________________________________________________________________________________ Zip/Postal Code:________________ State/Province:_________________ Country:__________________ Phone:____________________ Fax:____________________  Email Address:_______________________________ New Membership _____  Renewal _____ How many Lancashire Heeler's do you own? (please tell us about them!  Ages, color etc )_________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ Please tell us about your other pets... ________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ What are your Interests (please check those that apply): Breeding _____ Showing _____ Obedience _____ Herding _____ Other (please specify) ______________________________________________________________________________________ Would you be interested in helping with club tasks? ______  If so, please tell us how you'd like to help! ________________________ ________________________________________________________________________________________________________ Membership dues are $35.00 in United States funds and are due January 1st of each year. Please make cheque or money order payable to The United States Lancashire Heeler Club. I hereby make application to the United States Lancashire Heeler Club and agree, if accepted for membership, to adhere to the policies, guidelines, constitution and by-laws set forth by the club.  The above information is true and accurate.  I understand that my membership is subject to the club's approval. Sign ______________________________________________ Date ___________________________