NAME:
 ADDRESS:

 TELEPHONE NUMBER(S):

 EMAIL ADDRESS:

 KENNEL NAME:

  (Please indicate which of these categories best describes your activities with
   your dog)
 BREEDER:
 DOG OWNER:
 EXHIBITOR:
 JUDGE:

 INTEREST WITH DOGS:

 DOG CLUB AFFILIATIONS:

 NAME OF DOG AND BREED:

 ANY QUESTIONS OR COMMENTS:

 By applying for membership to the American Mudi Association, your 
 submission of  this application to the AMA secretary by email or land mail,
 you hereby agree to abide by the constitution, by-laws and code of ethics
 of the AMA and the rules of the American Kennel Club and United Kennel Club.
 9/1/2004