Sioux Empire Kennel Club

Helping dogs live better lives since 1961

 Sioux Empire Kennel Club

Member American Kennel Club

Name: __________________________________________     Occupation: _________________________________

Address: __________________________________City/State/Zip: ________________________________________

Phone home: _______________________ work: __________________________ cell: _______________________

Email: ________________________________________________________________________________________

List the dogs you currently own.  If more room is needed, please attach an additional sheet or put on reverse side:

              Name         Breed Birthdate Age

____________________________________   ______________________________  _______________  ______

____________________________________ _______________________________ _______________  ______

___________________________________  _______________________________  _______________   ______

Please list titles, if any, your dog(s) hold.  If more room is needed, please attach an additional sheet.____________

_____________________________________________________________________________________________

What are your areas of interest for your dog(s)?  Check all that apply.

Conformation: ____ Agility: ____ Obedience: ____ Therapy: ____ Family Dog Training: ____

Other: _________________________ 

Please describe other dog activities in which you are or have been involved.________________________________

_____________________________________________________________________________________________

What is your previous club experience? _____________________________________________________________

_____________________________________________________________________________________________

Have you taken training classes with SEKC or elsewhere?  Yes____No____ Please list classes and facility.

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Do you breed dogs?  Yes____No____ Name of kennel: _________________________________________________

Average number of litters per year. _________________________

Have you ever bred a non-registered litter? Yes____No____If yes, please explain:___________________________

Why are you interested in joining this club? __________________________________________________________

_____________________________________________________________________________________________

Have you ever been fined or suspended by the AKC or charged with violation of animal cruelty or neglect laws?

Yes____No____ If yes, please explain and describe.___________________________________________________

_____________________________________________________________________________________________

As an SEKC member, you will be encouraged to work on at least one committee to ensure our club and its activities are successful.  Please indicate which committee(s) you would be interested in working on.

____Training Classes ____Hospitality at Meetings ____Public Education Events

____Fundraising ____Event Planner or Worker ____Breeder Referral

____Agility Trial ____Fall Show ____Summer Obedience Trial

____Building & Equipment Maintenance ____OTHER:___________________________

I agree to abide by the Constitution and Bylaws of the Sioux Empire Kennel Club and I understand the duties and responsibilities of being a member.  A copy of the Constitution and By Laws is available on our website at or from the membership chair.


Applicant Signature: ____________________________________________________Date:_____________________


Sponsor Signature: ___________________________________Date:__________________

Sponsor Signature: ___________________________________Date:__________________


Please submit this application with a check made payable to: SEKC; ATTN: Secretary; PO Box719, Sioux Falls 57101.

Annual dues are $50 for a household; $ 30.00 for regular, $20.00 for jr. and 10.00 for the building access code.  Dues received between Aug1 and Oct 31 are ½ of the annual dues.  After November 1, full price dues will be applied to the following year.

OFFICE USE ONLY

Dues received on Date: _________________Check Number: ___________________

Eligibility Requirements Verified on Date: __________ Approved for membership on Date: ____________________