New Membership Application

Your Name (required):

Your Email (required):

Mailing Address:

City:

State:

Zip:

Home Phone:

Work Phone:

Dog(s)' Name and Breed:

New membership dues are based on a FULL calendar year (January-December). The amount that you pay is determined by WHEN you pay during that calendar year.

If you are paying dues for a NEW annual membership during the months of
January through August:

  • Dues are $20 for an Individual Membership and $25 for a **Family Membership.
  • Expiration: December 31 of the current calendar year.

If you are paying membership dues for a NEW annual membership during the months of
September through December:

  • Dues are $25 for an Individual Membership and $30 for a **Family Membership.
    ($5 extra)
  • Expiration: December 31 of the NEXT calendar year.

**Family Membership Names:

Amount you will be paying:

If you have any membership questions, please call Julie at 623-670-3000

Make checks payable to: Jumping Chollas Agility Club, Inc.

Mail membership form with check to:
JCAC-Membership
c/o Julie Grant
1515 West Encanto Blvd
Phoenix, AZ 85007