How Long Have You Been a Member of the NTCA ? (24 Months Minimum)

Applicant’s Information

Name ______Address ______City ______State______Zip ______Country______Phone______Email ______

Sponsor’s Information Name ______Address ______City ______State______Zip ______Country______Phone______Email ______

How long have you been a member of the NTCA ? (24 months minimum)

How long have you known the applicant? Months ____ or Years (if greater than 36 months) _____

Does the applicant have a Norwich Terrier(s) Yes __ # __ No __

Describe your relationship with the applicant during the above period: ______

Describe how the applicant cares for his/her dogs in his/her or kennel: ______

Have you visited the applicant’s home or kennel? Yes No

How many Norwich litters has the applicant bred during the period you have known him/her? ______

Does the applicant have a Norwich Terrier at stud? Yes __ No __

of 3 Does the applicant perform NTCA recommended health testing prior to breeding any of his/her Norwich Terriers? Yes __ No __ N/A __ If no, please ______

Have you verified health testing? Yes__ No __

Suggest any particular club committees on which this applicant might best serve the Club: ______

Does the applicant have enough time to contribute in a volunteer capacity to the NTCA? Yes __ No __ Don’t Know __

Does the applicant show his/her Norwich Terrier(s) in performance events, or companion events? Conformation __ Earth Dog __ Barnhunt __ Agility __Obedience __ Rally__ Therapy Dog __

Would the applicant commit to take back or re-home a Norwich Terrier that he/she bred or sold, if necessary, at any time of the dog’s life? Yes __ No __

Do you think the applicant is knowledgeable about the NTCA Norwich Standard to cast an “informed” vote on the Standard? Yes __No __ If no, explain: ______

Are you confident that the applicant will support the current approved NTCA Breed Standard? Yes __No __

Has the applicant attended any NTCA events or specialties? Yes __ No __ If yes, when? ______If no, why not? ______

Please comment on the reasons you are sponsoring this applicant for membership and indicate that he/she would be a positive addition to the club: ______

______

of 3 ______

NOTE: NTCA Bylaws require the club to do all in its power to protect and advance interests in the breed. Therefore the Sponsor’s responsibility is higher than ever. The Sponsor is required by the Bylaws to have had 24 months acquaintance with the prospective applicants. New Applicants need to read, understand, and sign the NTCA Code of Ethics. I understand that false or misleading information provided here may result in my expulsion. Sponsor must be in good standing with NTCA.

Sponsor’s Signature Date

NTCA Form 8-15-16