Membership Application Or apply online: Membership ApplicationFirst NameLast NameEmailPhone/MobileAddressAddress Line 1Address Line 2CityStateZip CodeCountrySelect CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)RomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweMembership Types: Full Membership ($15) - Persons 18 years and older who reside within the club's territory of the greater Portland, Oregon area (including communities north to Kalama, WA, south to Salem, OR, in proximity to the Interstate 5 corridor). Enjoys all club privileges including the right to vote and hold office. Associate Membership ($10) - Entitled to all club privileges except voting and office holding (offered to individuals who live outside of the club’s area; as well as to individuals who live in the club’s area but are not active). Household Membership ($25) — Two (2) adult members, 18 years or older, residing in the same household within the club’s territory of the greater Portland, Oregon area (including communities north to Kalama, WA, south to Salem, OR, in proximity to the Interstate 5 corridor), each eligible to vote and hold office Junior Membership ($0) - Open to minors under 18 years of age; a non-voting/non-office-holding membership which may automatically convert to regular membership at age 18. Choose the Membership Type you are applying for: Full Membership Household Membership Associate Membership Junior MembershipBreed(s) currently ownedBreed(s) owned in the pastBreeder/Exhibitor/Owner: Breeder (Bred and registered litters within the last three years) Exhibitor (Exhibited at AKC approved events within the last two years) Dog Owner (Owns a Registrable purebred dog(s), but not actively breeding, exhibiting, or judging Please Check all that Apply: Breeder Exhibitor Dog OwnerIf an Exhibitor, please check which activities you have been involved with: Conformation Obedience Rally Agility Herding Trials Lure Coursing/Fast CAT Tracking Scent WorkOther ActivitiesEvent Committee Experience Please indicate below if you have had any experience in the following; Show Chair, Secretary, Steward, Judge (include judges number), Other Job (describe any other job held at a dog event). Describe the situation including club and the years you have held the position.What other dog clubs do you currently belong to?What would be an area or areas you would be most helpful in? Education Fun Matches Fund Raising Hospitality Logo Design Marketing (Flyers, website, etc.) TrophiesOther area(s) By signing this application, I agree to abide by: All AKC rules, regulations, policies, guidelines, and the AKC Code of Sportsmanship. AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club Web site, www.akc.org And the Columbia River Herding Group Club Constitution and By-Laws.Sponsor #1, Name and email:Sponsor #2, Name and email:Type name in lieu of signature:DateNo payment items has been selected yetIf you have a coupon, enter it here:Apply CouponSubmit Form