Southern States Mastiff Fanciers
Membership Application

First Step:

You Must Read And Agree To Abide By The SSMF Code Of Ethics CLICK HERE

Name:

Kennel Name:

Occupation:

 

Street Address:
City: State: Zip:
 
Telephone: Home: Cell Or Fax:
E-mail: (Unless otherwise requested, newsletters and other club correspondence will be e-mailed and/or available on the SSMF web site)

Indicate here if you would rather receive your newsletter via US postal service.

List the names of other family members if applying for Family Membership

Is Your Primary Interest In

Pet               Show            

 Breeding       Obedience/Agility

 

Number Of Mastiffs You Currently Own INCLUDING all that you Co-Own

Number of Mastiff litters produced as Breeder or Co-Breeder in last 24 months:

Other breed/kennel clubs to which you belong and offices held (if any)

Have you ever been suspended by any breed/kennel club including AKC?  If so, please explain.

Are you able to help with:  Fund Raising                   Fun Match/Show                            Rescue (SSMR)

 

Mailings                           Photography                    Newsletter Articles                         Board Member

 

Trophies                           Events in your area         Regional events                             

 List Any Other Ways You Can Help       

I hereby swear that the above statements are true, that I am 18 years of age or older, and that I have read and agree to abide by Southern States Mastiff Fanciersí Code of Ethics.

Signature Type your full name as this will be considered your digital signature.

Date Signed

SSMF yearly membership dues are $15.00 Individual/$20.00 Family if a check is mailed. If using our paypal link dues are $17.00 individual/$22.00 Family. Indicate in the space below if you are paying via paypal or if you are mailing a check to pay your dues.

   

Return to the top of the page to submit form. Then submit your dues either via paypal or if mailing a check, to the address below.