Print and Submit Membership Information and Payment to:
Kelly Roth
OCC Secretary Treasurer
2003 Nelson St. Box 217
Gorrie, ON N0G 1X0
Email : kjroth@wightman.ca
Ontario Cavy Club Membership Application
New _______ Renewal _______
(Family $20.00 Adult $16.00 Youth $12.00)
Last Name ________________________________________ First Name ___________________________________________
Additional Name(s) for Family Membership ____________________________________________________________________
Address ________________________________________________________________________________________________
City ______________________________________________ Province/State __________________________________
Postal/Zip Code ____________________________________ Phone Number __________________________________
Email Address ______________________________________________________ May we publish your contact info? Yes No
Breeds Raised ______________________________________________________________________
Cheques or money orders please.
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