LET WEL: Slegs u eie naam, die naam waarop u tjek rekening bedryf word, of 'n geregistreerde Stamboek voorvoegsel mag gebruik word. 
N.B.: Only your own name, the name on which your cheque account operates, or a registered Stud Book prefix may be used. 

Volledige Posadres:                                                                                               Kode: 
Postal Address: ...................................................................................................  Code: ............................. 
Naam van plaas waar Dorpers geteel word: 
Name of farm on which Dorpers are bred: ................................................................................................... 
Distrik:                                                                                      Provinsie: 
District: ................................................................................... Province: ...................................................... 
Van wanneer af teel u Dorpers? 
Since when have you been breeding Dorpers? ............................................................................................ 
Wit of Swart Kop: 
White or Black Head: ..................................................................................................................................... 
Beknopte geskiedenis van u kudde: 
Brief history of your flock: .............................................................................................................................. 
........................................................................................................................................................................ 
........................................................................................................................................................................ 
........................................................................................................................................................................ 
Moet oorplaatjies bestel word vir die inspeksie van u kudde? 
Must ear tags be ordered for the inspection of your flock? ........................................................................... 
Wie is u naaste inspekteur?  
Who is your nearest inspector? .................................................................................................................... 
Briefwisseling in Afrikaans of Engels? 
Correspondence in English or Afrikaans? ..................................................................................................... 
Telefoonnommer/Telephone number: ........................................................................................................... 

Ingesluit geliewe 'n tjek te vind vir R480,00 vir onderstaande bedrae. 
Enclosed please find a cheque for R480,00 as specified hereunder. 

Affiliasiefooi/Affiliation fee         R  60,00 
Ledegeld/Subscription               R500,00 vir jaar eindigend 31 Maart/ for year ending 31 March 
                                                      R560,00 

Ek die ondergetekende is bewus van en onderneem hiermee om aan die Grondwet en Reëls van die Dorperskaaptelersgenootskap van S.A. onderhewig te wees.  
I the undersigned am aware of and hereby undertake to subject myself to the Constitution and Rules of the Dorper Sheep Breeders' Society of S.A.  

Datum:                                                                            Handtekening van Applikant: 
Date: ......................................................................        Signature of Applicant: ...........................................