Membership Renewal Form

Renewal Form








  • First Name Last Name  
    Add a new row
  • Regular – 0-19 volunteered hours for BKC in the past year.

    Contributor – 20-59 volunteered hours for BKC in the past year.

    Sponsor – 60+ volunteered hours for BKC in the past year.

    Please list hours in the box below. Include attendance at general meetings.
















  • If this is your cell phone, please just list it here. You don’t have to fill out the “Cell Phone” field.
  • UKC, etc

    Breed Name Registry Organization  
    Add a new row
  • Primary Breed Secondary Breed  
    Add a new row
    Please describe your best guess at the top two primary breeds in each dog’s background.
  • What services are you willing to provide to people interested in the breeds you are knowledgeable of.





  • Please indicate which areas you’d like to volunteer in.































  • Enter the year you joined BKC as a member.

  • If paying by check, submit the application and send your check to:

    Karen Scott
    5453 Lake Mendota Drive
    Madison WI 53703
    Phone:
    scottiekl@sbcglobal.net

  • $0.00
  • This field is for validation purposes and should be left unchanged.

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