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ACT and District Staffordshire Bull Terrier Club Inc.
Affiliated with the ACT Canine Association
Membership Form July 2003-June 30th 2004

New membership / Renewal
Name:______________________________________________________________________________________
Address:____________________________________________________________________________________
Phone:________________________________________Fax:_________________________________________
Mobile:______________________________________email:_________________________________________
ACTCA or State Controlling Body Membership No_______________________________________________

I/We wish to apply for membership of the ACT & District Staffordshire Bull Terrier Club and agree to abide by the constitution/ethics of the club.
Signed______________________________________Dated________________________

Membership fee being $_______________ Family $30 Dual $20 Single $15 Overseas subscriptions to be in Australian Dollars

* Please note that there is no longer a junior/pensioner membership Breeders Directory $5.00 for members and $10.00 for non members

Prefix and contact number___________________________________________________________________
Stud dog directory $5.00 per dog_____________________________

Puppy Listing $10.00 phone, $15.00 Phone and newsletter
Magazine advertising full page $75.00 per year
$25 casual rate per magazine

Do you own a Staffordshire Bull Terrier Yes/No

Please send your remittance to:

With cheques made payable to The ACT and District Staffordshire Bull Terrier Club
Linda Birkeland
PO Box 6055
Lanyon LPO
ACT 2906

If you wish to have your dogs photos published in the clubs magazine you must supply the club with a photo of your dog/s which will become the property of the club for use when publishing results.