ETRC Membership Application

Please fill out the following form, print it, and send with your $25 to our treasurer. When we receive your information, we will add it to our website if requested.  Annual renewal date: March 1.
 
Mail this form & dues to:

Chuck Atchley
1927 Kings Estate Rd
Sevierville, TN 37876
 
 
First name:
  
Last name:
  
 Spouse name:
  
Street address:
  
City:
  
State:
  
Zip Code:
  
Phone:
  
 Work Phone:
  

Cell Phone:

  
E-mail:
  
 
Dog Full Name & Titles Breed Age
     
     
     
     

 
Judging Experience?

 q Puppy    q Junior  q Senior   q Master
 
Please Check Primary Interests:
qAKC Hunting Tests
qField Trials 
qHunter's Safety Course Compl		 qDog Training 
qClub Trials 
qDucks Unlimited Member		 qNRA Member 
qJudging/Judging Clinics

Other: