Minnesota Iron Range Retriever Club P.O. Box 661Virginia, MN 55792 NEW MEMBER APPLICATION FORM(Please print all information) Date _________________________________Name __________________________________________________________________________________ Address ________________________________________________________________________________ ________________________________________________________________________________E-mail Address __________________________________________________________________________ Phone Numbers (include area code) ________________________________________________________ Membership Level (Check One): Participating ($60) _____ Annual ($60) ______ Life ($600) ______ After 16 hours of work at club events and grounds work, the Participating Member dues for the following yearwill be $10. Event dates are listed below. Club activities in which you are interested in participating (Check One or More): Attend club meetings ________________ Help with grounds improvement ________________ Help with food service ________________ Serve as a club officer or committee member ________________ Throw dead birds or shoot popper guns at trials or tests ________________ Throw live birds at trials or test ________________ Live-gun at trials or tests ________________ Judge (or learn to judge) Area of dog training in which you plan to participate (Check One or More): Informal Field Trials ________________ HRC Tests __________________ Licensed Field Trials ________________ NAVHDA __________________ Licensed Hunt Tests ________________ Train dog for hunting ________ Participating Membership Activity Designation:As a participating member, please select which two days you likely will be able to help at the club this year. An event chair will call you to confirm these dates. Below is the tentative schedule for 2022 – circle the days you will help out. The club website www.mirrc.org will also list club events.Informal Field Trials . . . . . . . . . . . AKC Hunt Test . . . . . . . . . . . . . . . AKC Field Trial #1 . . . . . . . . . . . . AKC Field Trial #2 . . . . . . . . . . . .Saturday, April 30 Saturday, July 3Friday, July 22 Friday, July 29Sunday, May 1Sunday, July 3Saturday, July 23 Sunday, July 24 Saturday, July 30 Sunday, July 31 I will abide by the Minnesota Iron Range Retriever Club by-laws and the rules and procedures of the American Kennel Club. Sponsor ______________________________ Signature _________________________________________ Sponsor ______________________________