Michigan 
Versatile Hunting Dog Federation 
2011 Membership


_________________________________________________________________________________________
Last Name                                                                          First Name


_________________________________________________________________________________________
Address

_________________________________________________________________________________________
City, State and Zip Code

_________________________________________________________________________________________
E-mail Address

_________________________________________________________________________________________
Telephone Number

_________________________________________________________________________________________
Breed                                                                                             Number of Dogs


Make check payable to: Michigan VHDF                            Membership Fees expire on: January 1, 2011
                                                                                                                           
Mail To:                                                                                ________ Single Membership - $25.00
Cindy Petkwitz                                                                            
18554 Mack Ave.                                                                   ________ Family Membership - $35.00
Grosse Pointe Farms, MI 48236                            
                                                                                                      Family Membership includes:
                                                                                                      Spouse & children under 18 years old
                                                                                        
List family member names below:                                                                                                            
                                                                                           Versatile Hunting Dog Federation             
________________________________________                             Membership Number: _____________

________________________________________

________________________________________