ONLINE MEMBERSHIP APPLICATION

** Notice: If you apply online, you must also pay with Paypal online! **

•Members annual dues are $15.00 per calendar year for one or two people plus their children (non-voting members) at the same address.
New Members Discount after January new members pay $1.25 multiplied by the number of months remaining in the year.

 

* This application is used to prepare the roster, newsletter mailing list and verify voter eligibility. The annual roster is due out in May of each year. If breeder birds or an Avian associated businesses are not listed, you will be a listed as a PET OWNER without any birds or business being listed.

WE DO NOT USE LAST YEAR’S INFORMATION - YOU MUST SUBMIT A NEW APPLICATION EACH YEAR.

Name


Mailing Address
Street (not in roster)
City State Zip (city, state, and zip in roster)

Contact Info
Phone (in roster) Fax (in roster) Cell (not in roster)
E-mail (in roster)
Website (in roster)

Miscellaneous Information
Avian Topic/Topics You Can Speak On (not in roster)
Avian Associated Business (in roster)

Breeder Birds (in roster)

Payment Info
Amount Paid by Paypal:


 

 
 

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