Membership Card

Last Name

First Name

Middle Name

Phone

Date Of Birth

Place Of Birth

Sex

Male

Female

Citizenship

Filipino

Others Please specify

Educational Attainment

High School

College

Masters

Complete Home Address

City / Municipality

Province

Zip Code

Employment

Private

Government

Self Employed

N/A

Employmer's Name

Employment Address

Would you like to participate in our dog shows?

Yes

Can we call you to help in our club activities?

Yes

I apply to become a MEMBER of the Philippine Canine Club, Incorporated, and in so doing I expressly acknowledge the jurisdiction of the Philippine Canine Club, Inc (PCCI) as the SOLE governing body in the Republic of the Philippines with respect to all canine affairs and I agree to abide by all Rules, Regulations, Resolutions and By - Laws of the Philippine Canine Club, Inc. and/or its Board of Directors, which may be in force during the period of membership.

Membership Card

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