EARTHWORKERS UNLIMITED, INC
                                                  
                                                      Membership Application



                        NAME ______________________________________________________________________________

                        ADDRESS ___________________________________________________________________________

                        CITY_____________________________________STATE ______________ZIP____________________

                        PHONE_________________________E-MAIL_______________________________________________

                        OCCUPATION ________________________________________________________________________

                        KENNEL NAME _______________________________________________________________________

                        Primary interest(s) in dogs:

                                Exhibiting       Working          Agility         Companion            Rescue    

                                        Obedience     Breeding         Earthdog           Other     

                       Breeds presently owned ________________________________________________________________

                       Number of dogs presently owned ________________________________________________________

                       List the Dog clubs to which you belong/have belonged and offices held and reasons for leaving

                       _______________________________________________________________________________________

                       _______________________________________________________________________________________

                       _______________________________________________________________________________________

                      Are you presently in good standing with your Breed/All-Breed Club(s) ? _____________________________

                      I am willing to participate on a committee where my services can be of benefit to the Club ______________

                      I agree to abide by the Constitution and By-laws of EWU, Inc.

                     Signature____________________________________________________ Date ______________________

                                                Dues: $ 25.00- Single __________ $30.00- Family ___________

                     Make checks payable to: EWU

                     Mail to: Cathy Greenfield   10250 Woodbury Rd.      Laingsburg, Mi 48848