California Houndsmen for Conservation Membership Application

Please indicate (electronically or by hand) the appropriate information in each of the fields provided.

Date: Member Birthdate: Spouse Birthdate:

First Name: Spouse Name: Last Name:

Street: Apartment Number:

City: State/Province: Country: Zip:

Phone Number: Email Address:

 

Please choose one of the following membership options. For a multi-year membership, indicate total years:

Individual (@ $20.00/year) Family (@ $25.00/year) Lifetime (@ $200.00)

     

     

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I would like this donation directed to the following entity (Please indicate one):


 

Total Amount Enclosed: $

 

Please include me in regular email and/or mailing alerts of pending legislation, and notices of local, state, and national efforts to defend and promote hound hunting from CHC, its partners, and affiliates.

Please provide me with more information on how to join regional clubs local to me.

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If completed electronically, use your Internet Brower's "Print" button to create a copy of the application. Please send the completed application with dues/donation to:

Irv Corbin, Secretary

18850 Saddleback Ridge Road

Cottonwood, CA 96022-9699

530.347.3327

membership@californiahoundsmen.com

*Please make check payable to "CHC"

**For tax purposes, please indicate Occupation and Name of Employer, and make check payable to "SPVF"

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