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Membership Application Form


> About PPPCA > Membership Application > Membership Application Form

Membership Application Form

When submitting your membership application, please remit your dues by mailing a check to the PPPCA. Annual Dues are $30 per person, $50 for two adults in the same household and $5 Jr. Members (under 18 y.o.). Once your application and dues are received, your name, with city and state of residence, is sent to the full PPPCA membership for a 20-day comment period, two sponsors are identified, and the PPPCA Board votes on your application. Thanks!

Click Here to Pay Online and please remember to fill out this online application. Or, print it out, complete it, and send back, with a check payable to PPPCA to:
Becky Berkley, PPPCA Membership Chair
11655 Vaca Place
San Diego, CA 92124

PPPCA Membership Application:
New Member: Renewal:
First Name:
Last Name:
Occupation:
Address:
City:
State:
Zip:
Phone:
Number of Podengo(s) Owned:
Dog Name(1):
Type:
Variety:
Sex:

Male: Female:

Dam:
Sire:
Breeder
If only one or no podengos owned scroll down to comments.
Dog Name(2):
Type:
Variety:
Sex:

Male: Female:

Dam:
Sire:
Breeder
Dog Name(3):
Type:
Variety:
Sex:

Male: Female:

Dam:
Sire:
Breeder
Dog Name(4):
Type:
Variety:
Sex:

Male: Female:

Dam:
Sire:
Breeder
Dog Name(5):
Type:
Variety:
Sex:

Male: Female:

Dam:
Sire:
Breeder
Dog Name(6):
Type:
Variety:
Sex:

Male: Female:

Dam:
Sire:
Breeder
More than 6 podengos? You'll need to submit another form.
Are you interested in breeding, showing, obedience training, other?
Please describe:

In consideration of my acceptance into membership in this club, I hereby agree not to hold the Portuguese Podengo Pequeno Club of America, it's officers, directors, or training instructors, nor the landlord(s) of the property and building where club events are held, liable for any loss or damage that may occur to my person or property as a result of my participation in club activities. Furthermore, I have read the PPPCA By-Laws and the PPPCA Code of Ethics (see PPPCA Section of this website) and agree to abide by them.

Yes, I agree to the above statement.