CPHA MEMBERSHIP APPLICATION  -   Please complete the following application form in full:

CKC membership number______________

Name________________________________________________________

Address_______________________________________________________

City_______________________Prov____________Postal Code_________

Phone: Home______________Business_____________Fax_____________

Email________________________________________________________

How long have you been involved in dogs?__________________________

What is your experience in dogs?___________________________________

Have you ever worked for a handler?____________

Please give name(s) and length of time employed_____________________
_____________________________________________________________

Have you any other experience that you feel will be beneficial in the profession of handling dogs?

_____________________________________________________________

Do you own___________________lease_______________kennel facilities.

If leased, please provide a copy of the agreement.

What is your dog show vehicle?  Please include type,year and make of vehicle.

_______________________________________________________

Have you ever been reprimanded or disciplined by the CKC? Yes___ No__

If yes, please give details_________________________________________
_____________________________________________________________

On the following page, describe your kennel facilities and include pictures and diagrams.

Also, please enclose with this application your business card,
contract, fee schedule, letterhead, sample billing.

Signature of Applicant___________________________________________

Please print name_______________________________________________

Date_________________________________________________________


Signature of CPHA Member # 1___________________________________

Date_________________________________________________________

Signature of CPHA Member # 2__________________________________

Date_________________________________________________________

Click for the Apprentice-Candian Professional Handlers Assoc application



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