Today’s Date:

Complete form with your information. Mail completed form to address below. Please print clearly.

New  or  Renewal

Name

 

Address

City, State, Zip

 

Email

 

Dog’s Name(s) and Breed(s)

 

 

Phone

 

Membership Fee:

$10 per year per person

or 3 years for $25 per person 

Please Circle One    Donations gratefully accepted!!

1 Year $10      2 Years $20    3 Years $25

I hereby declare that I am a responsible dog owner, providing love at all times, and vaccinations and medical care whenever needed.  I declare that I intend to keep my dog under control, both on and off leash, whether at an M-DOGS group event, or any other time I am out with my dog.

Signed:

Please make checks payable to M-DOGS. Please note "M-DOGS membership" on memo line.   Incomplete or illegible forms will be returned.

Mail completed form to: 
MDogs C/O John Carlos

2771 Glen Ave

Merced, CA  95340