1.Fill out Form  2.Click Print  3.Sign & Date  4.Mail to address below

Verein Deutsch-Drahthaar/Group North America Membership Application: Calendar Year:

New Member Application   Request for Reinstatement after Lapse in Membership

Transfer from other VDD Group:
Social Membership: Primary Membership is with VDD Group:

Where did you first learn about VDD/GNA?  GNA member  website  Gun Dog ad  PDJ ad
Where did you obtain your information and application? Breeder  GNA Nat'l Rep GNA website
Name: (first, middle initial, last)
 		Salutation:
(Mr., Dr., Mrs., Ms.)
Informal first name: (nickname)
Street address:
Mailing Address:
City:
 State:
 ZIP:
Country: (if other than USA)

Home phone:

Mobile phone:

Fax:

Email:

* Date of Birth:

* Occupation:

Spouse's Name:

*Important - your application cannot
be processed without this information.
Incomplete applications will be returned.

* I am a licensed hunter or I am a hunter who is not required by law to have a license to hunt
   in my state or country of residence. YES   NO

Please list all VDD registered Deutsch-Drahthaars and/or other FCI recognized dogs below: 
 Use an additional sheet of paper for additional dogs.

Registration #: Registered Name: Breed (DD, DK, etc.): Whelp Date:

All membership fees include $25 for a subscription to the VDD/GNA newsletter, published in
January, March, May, July, September, and December.
 $100.00 - New Member Dues and Initiation Fee enclosed
 $50.00 - New Member Dues and Initiation Fee enclosed: ONLY applicable to members under 25 years of age, without regular income, and living in the same family household where at least one parent is a VDD member. NOTE: This member will not receive periodicals.
Please provide name of parent who is a current VDD member:
 $25.00 Social Member Dues enclosed (only for those who are already regular members of another VDD Group - specify above)

Dues are payable for calendar year. Dues received on or after Oct 1 will be credited for following year.

 In addition to the VDD/GNA newsletter, I would also like to receive the Deutsch-Drahthaar Blätter
(Monthly newsletter from parent breed club - printed in GERMAN) Yes No
I hereby agree to comply with the Constitution and Bylaws of the Verein Deutsch-Drahthaar and VDD Group North America, and with the VDD Breeding Regulations. I further agree to notify VDD Group  North America in writing prior to November 15 if I should not intend to renew my membership for the following year. I realize that failure to notify VDD/GNA by that date will obligate me to remit the annual membership dues for the following year.
Signature: Date:

Mail check or money order made
payable to VDD/GNA to:

Jim Wion, VDD/GNA Business Manager
2703 Marble Springs Rd.
Barnhart, MO  63012-2327