Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

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###

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What membership are you interested in? *

Individual Membership $20

Joint Membership $30

Junior Membership $ Free

Foreign Membership $25

I have read and understand the current WBA Constitution, Bylaws, and Member Code of Ethics? *

Yes

No

I agree to accept electronic communication as the official means for the Working Beauceron Association, including email, phone, audio/video conferences, or other Board-approved methods. This will be used for meeting notifications, dues notices, minutes, newsletters, and announcements. *

Yes

No