BWTA Membership Application
Please print out and mail this form, with membership dues, to:

BWTA
c/o Mary Anne Hauck
1904 Milburt Drive
Louisville, KY  40223-1212

Name(s):_____________________________________________

Address:_____________________________________________

City/State/Zip:________________________________________

Phone #/email:________________________________________


Breeds of dog(s) you own:_______________________________
____________________________________________________

Sponsor:_____________________________________________

Are you interested in helping at events?  Yes/No
Which activities?______________________________________

Membership is $20 annually per household, checks payable to BWTA.  For more information, email Mary Anne at:  patterdale@aol.com.