DAR Member Application

Membership Application

Send all Donations to:

12 Twisted Oak Street Brampton, Ontario L5R 1T1

See below for items we are collecting

Date:_________________

Name:_____________________________________________________________

Address:___________________________________________________________

City:_______________________Province:___________Postal Code:__________

Phone #::__________________ Email:__________________________________

Please Check Membership Status

Renewal New

Please Check Membership Category:

General Member $20 per year

Active Foster Member $10 per year - is actively fostering dogs throughout the year.

Additional Donation Enclosed? Yes Amount $_________ No

Signature:_________________________________ Date:_______________

Personal Data:

Do you have any pets?________ Species, Names & Ages:

_____________________________________________________________

_____________________________________________________________

Do you breed dogs?_________What breeds: _____________________________________________________________

_____________________________________________________________

How long have you been a breeder? _______________________________

All breeders who wish to be affiliated with DAR must comply with the DAR ethical breeders mandate. Please call 905-458-1883 if you need a copy of the mandate. Make all cheques payable to "Dalmatian Adoption & Rescue". The membership year is from Jan 1 through Dec 31 annually. Thank you for your support.

We are collecting the following items

Canadian Tire Money

Collars

Leashes

Old Blankets

Tennis Balls

Tug Ropes

Old Crates

And....money for all the vet care

geophysics@compuserve.com

Contact us at: 905-458-1883