GREAT PYRENEES CLUB OF THE SOUTHEAST 

MEMBERSHIP APPLICATION 

Please Type or Print Clearly 
Applicant(s) Name(s) ___________________________________________________________________ 
Address 
Mailing Address (if different) 
City, State Zip 
Phone Number 
Fax Number 
Email Address 
Website 
DOG INFORMATION 
If you own a Great Pyrenees, how many do you own? How long? 
Briefly describe your interest in the breed: 
MEMBERSHIP 
Single or Charter membership $ 30.00 
Double membership $ 45.00 
Family/Household membership $ 50.00 
Junior membership $ 10.00 
Lifetime membership $ 250.00 
OFFICE USE ONLY 
Date received: 
Amount received: ________ 
Please make check payable to: GPCSE 
Send completed application and dues to: GPCSE, 170 Hall Rd, Griffin, GA 30223 
Total Amount enclosed: $________________ 
JUNIOR 
MEMBERSHIP: 
Junior member sponsor 
Junior member parent/guardian signature (please print name with the 
applicants name) 
By submitting this application, I agree that I have read and promise to abide by the Constitution, Bylaws 
and any Code of Ethics presently adopted by the Great Pyrenees Club of the Southeast and to uphold the 
aims and goals of the organization in so far as I am able. 

Membership is good for one year from date received as followed in the constitution and 
bylaws. All members are able to participate in all shows and other club functions.