Membership Application

Please submit this information, and you will be taken to the membership payment page. Please make sure the name and address on this form match the name and address used when paying through PayPal. If you prefer NOT to pay on-line, please use the printable membership application and mail it with a check. The printable application is found on the "Membership" page (button above.)

Is this a new membership?		(Yes/No)
Is this a renewal of an existing active membership?		(Yes/No)
Is this a change of information submission? (complete the entire form):		(Yes/No)
Your Full Name:
Names of Additional Participating Family Members: ($5 each)
Street Address:
City/State:
Zip:
Phone:
Email:
Re-type primary email:
Alternate Email:
Alternate Phone:
Are you a Member of a DSA troop?:
If so, what troop number?:
Do you want more information on starting a troop?:
Dog Name:
Dog Breed:
Registering as a Cadet Scout? ($5):		(Yes/No)
I have read and agree to uphold the Dog Scout Laws:		(Yes/No)
Dog Name:
Dog Breed:
Registering as a Cadet Scout? ($5):		(Yes/No)
Dog Name:
Dog Breed:
Registering as a Cadet Scout? ($5):		(Yes/No)
Information About Additional Dogs:
Date Submitted:

PLEASE COMPLETE THE ABOVE APPLICATION AND CLICK ON THE SUBMIT BUTTON. This will take you to the payment page for your membership and/or Cadet Scout payment.

Each Pay Pal button is linked to a specific amount based on your selection. Only click ONE Pay Pal button.

If you have questions, contact: DSAmembership@gmail.com