Membership Form

membership form

* Indicates required field

Name *

First

Last

Address (add Phone number under Line 2 or comments) *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Membership Type *

Foreign Membership: Add $5.00 per one year and $12.00 for three year.

If Youth Membership please add Date of Birth in comment below.

Please add a comment below if you want your information listed on the breeders directory on this website. Also add your website address if you want it listed.

Comment *

Submit

Please print this page before you click Submit above (or you will have to fill out again). Once printed mail to the following address:

Payment must be sent via mailing address. Paypal is not yet available at this time.

Mary Ellen Stamets
37 Brown Street
Flemington, NJ 08822
(908) 782-0462
mrabbit67@yahoo.com