APPLICATION FOR CHODSKÝ PES CLUB (KPCHP) MEMBERSHIP FIRST NAME

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PŘIHLÁŠKA DO KLUBU PŘÁTEL CHODSKÉHO PSA

Application for Chodský pes Club (KPCHP) membership


First name :………………………………………………………………………………

Surname :………………………………………………………………………………..

Address :…………………………………………………………………………………

Postcode/ZIP code :………………………………..Country : ……………..…………


Name of your kennel : ………………………………………………………………….

Reg. number of your kennel : …………………………………………………………..

Your date of birth :………………………………………………………………………

Phone number :…………………………………………………………………………

e-mail address :……………………………………….…………………………………


Your chodský pes dogs :

Name Kennel Reg. number

…………………………………………………………………………………………………...

…………………………………………………………………………………………………...

…………………………………………………………………………………………………...


I hereby agree to the use of my personal data by KPCHP and Czech major kennel clubs (CKS and CMKU).

I agree to abide by KPCHP rules.


Your signature :………………………………… Date :……………………..


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Please pay the membership fee:


IBAN: CZ07 0300 0000 0001 6270 5919

Account number: 162705919/0300

BIC: CEKOCZPP

Name of account: Klub přátel chodského psa v ČR

Owner of account: Klub přátel chodského psa v ČR, U Pergamenky 3, 170 00 Praha


Fees – members from abroad


1st calendar year - member 650 CZK

Family member 100 CZK

Please send the application and a copy of the payment confirmation to the following address:

Karel Peroutka, Letiny 5, Blovice, 336 01, Česká republika.


2nd and following years :

the payment till the end of January 550 CZK

after payment – member 650 CZK

Family member 100 CZK

Please send a copy of the payment confirmation (.jpg or .pdf) and information about changes in address, dogs, etc. by e-mail: [email protected] .



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23 DATE FEBRUARY 23RD 2009 SUBJECT APPLICATION


Tags: (kpchp) membership, first, membership, application, chodský, (kpchp)