Right click on application and click print
Oakridge Pointing Dog club
P.O. Box 136
Curllsville, Pa 16221

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Date___________

Name___________________________Home phone____________

Address_______________________________________________

City_____________________ State____________ Zip__________

Occupation_______________________Work Phone____________

Email Address_____________________

Birthdate_____________Married  Yes or No   

Spouses name__________________________

Breeds owned___________________________

Other Clubs Affiliations____________________________________

Sponsor__________________Sponsor Signature________________

Applicants Signature______________________Date_____________

Dues Must Accompany Application. $30 per year
Membership runs January to January  

Single___________

Spousal___________

Application Approved     Yes   Or    No           Date_______________

Questions should be addressed to
President Bernie Gray
724-794-2217