Print and Submit Membership Information and Payment to:

Randy Kuntz

130 Stonehaven Drive, Waterloo, ON, N2L 6B2
 

 Email : randeye@golden.net

 

 

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.

PayPal is currently unavailable.

free templates
Make a Free Website with Yola.