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Please print, complete and forward us this membership
application with your membership fee. Cheques or money orders
should be made payable to The Parrot Association of Canada .
Annual Membership fee with Printed Journal:
Single or Family………….……. $35.00
Club or Association…………… $50.00 |
Annual Membership fee with Electronic Journal:
Single or Family………….……. $25.00
Club or Association…………… $40.00 |
Complimentary Annual Membership
- paid by Breeder (includes Electronic Journal):
Single or Family………….……. $25.00 |
Last Name: ...........................................................................
First Name: ...........................................................
Address: ...........................................................................................................................
Apt: ..........................
City: .....................................................................
Province: .............................. Postal Code: ............................
Email: .....................................................................................
Home Phone: .......................................................
Business Phone: (...........) - .........................................
Fax: (............) - ..............................................................
Occupation: ..........................................................................................................................................................
Single Family Spouse's
Name: .............................................................................................
Club
or Association Ass'n
Name: ..................................................................................................
I
am a parrot owner Bird
Types: ...................................................................................................
I
am a parrot breeder Bird
Types: ...................................................................................................
Aviary Name ...............................................................Web
Site ..........................................................................
Signature: ...........................................................................................................
Date: .........................................
Please check applicable payment
method:
Cheque or money order enclosed. Mastercard
Visa
Card Number: ..................................................................................................
Expiry Date: ...............................
Name as it appears on the card: ............................................................................................................................
Authorized Signature: ............................................................................................................................................
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