President Bill Brown
Vice President Frank Petro
Secretary Rob Pogue
Treasurer Todd Rittko
Board Members: Chuck Hagan
Date _ Phone _
Name _ Sponsor: __________________
Street _ E-mail Address:____________________
State _ Zip Code _
Breed of Dog _ Number of Dogs _
Dog’s Level of Achievement: Owners Level of Handling:
Puppy _. Novice _.
Started _. Beginner _
Intermediate / Seasoned _. Moderate _
Senior / Finished _. Experienced _
I have received ____ or applied _____ for PA Child Abuse History Clearance.*
Type of Membership: Amount Enclosed:
Individual $15.00 .
Family $25.00 .
Junior (under 18) $ 5.00 .
Referred by _
Please mail completed application and membership dues to:
Rob Pogue, Secretary
302 Buckingham Road
Pittsburgh, PA 15215
Make checks payable to: SWPAHRC