Affiliate Club Application

To apply for new Affiliate Club Membership, submit the form below and mail the required documents to Lori Buxton, BCSA Corresponding Secretary.

Club Name

Club Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Contact Name

First Name

Last Name

Contact Phone

(###)

###

####

Contact Email

Membership Type

Meeting Notices

YES Send BCSA meeting notifications by email

NO Send BCSA meeting notifications by US mail

Agreement

I Agree To comply with BCSA's Code of Ethics. To support the Constitution and Bylaws of the Border Collie Society of America. To strive to fulfill the Mission and Vision of the Border Collie Society of America. (Clicking yes serves as my signature.)*

Yes

No