Manitoba Stock Dog Association

2010  Membership Form

Last Name:          ___________________

First Names:

1.    ______________

2.    ______________

3.    ______________

4.    ______________

Mailing Address: ______________________

                             ______________________

                             ______________________

Telephone #:      _______________________

Email address:    _______________________

Membership Fee:      Single: $20.00

Family: $30.00 (consists of 2 adults and 2 children under 18 of the same family}

Make cheque payable to "Manitoba Stock Dog Association"

{MSDA} and mail to:

Manitoba Stock Dog Association

C/o Rick Willetts

Box 266

Eriksdale, Manitoba

R0C 0W0