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BBHC Membership Application

Please complete the form below to submit your application for membership in the Badgerland Basset Hound Club.

Name: *

Street address: *

City: *

State: *

Zip Code: *

Phone Number: *

Email Address: *

Occupation:

How many bassets do you own?: *

List the names (and ages, if known) for your bassets:

Do you offer puppies?:

No

Yes

Do you offer stud service?:

No

Yes

What are your interests (select all that apply):

Conformation

Obedience

Tracking

Field Trials

Agility

Rally

Rescue

Why are you interested in joining the club?: *

Please select the membership type: *

Family ($20.00)

Single ($15.00)

Associate ($10.00)

Please mail a check for membership payment made out to BBHC. Mail To:

Lisa Painter
4605 Dream Lane
Madison, WI 53718

Please list two current members that will endorse your membership: *

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