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 :……………………..
------------------------------------------- cut here ---------------------------------------------------------
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] .
2018 INTERNATIONAL SUMMER SCHOOL COURSE TEACHING APPLICATION FORM
20XX WRITTEN QUESTIONS ON APPLICATION GUIDELINES AS WE
23 DATE FEBRUARY 23RD 2009 SUBJECT APPLICATION
Tags: (kpchp) membership, first, membership, application, chodský, (kpchp)