Wufoo
Membership Application
If you ever intend to breed your dog, please fill out the Trusted Breeder Certification application.
You can join us as long as you agree to the rules.
Rules for new applicant joining as a puppy owner only:
a. Person is not allowed to mention that they breed. Can not mention new litters or that they have bred their dogs in any way. No website links in chat email. If said person wants to show pictures of puppies then this is allowed if they do not mention that they own the mother or father or that they have had them as a litter that they own.
b. Person must wait one year to be voted upon to become a Trusted Breeder and pay the Certification Fee. Said person must show interest in the society by becoming active in society activities such as but not limited to: photo contest, newsletter, chat, raffles, donations, and volunteering for jobs. Overall allowing the other society members to get to know said person very well.
c. Person must be courtious and kind in chat. It there is an issue said person agrees to take it out of chat. If the problem can not be resolved then said person agrees to bring it before the Trusted Breeders at which time a meeting will be held to with the two parties to air their differences and mediate. If there is any rudeness in chat to another, said person agree to an immediate removal from the playhouse chat.
Date
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MM
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DD
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Name
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First
Last
Address
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Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
United States
United Kingdom
Australia
Canada
France
New Zealand
India
Brazil
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Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Democratic Republic of the Congo
Republic of the Congo
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
Country
Phone Number
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Email
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How many Imperials do you own?
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1
2
3 or More
Spayed or Neutered?
*
Yes
No
Have you ever bred your dog?
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Yes
No
Do you intend to breed your dog/dogs?
*
Yes
No
Where did you purchase your dog/s?
*
How did you find our Society?
*
Yahoo
Breeder
Other
Do you have a sponser? Please tell us your sponser's name.
*
What would you like to get out of your membership in the society?
*
Would you like to volunteer for any jobs? Such as newsletter, photo contest, etc?
*
Do Not Fill This Out
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