
Name Caviary Name Address City State Zip Phone ARBA Membership Number (if you have one) Email: Breeds of Cavies Raised Names of all Family/Partnership Members (List birthdate of Youth Members) Organizational affiliation Dues: (Circle one) Annual 2 Year 3 Year Individual $ 10.00 $15.00 $20.00 Family/Partnership $15.00 $20.00 $30.00 Youth $ 8.00 $12.00 $18.00 Associate Member $ 9.00 Newsletter (only) |
| Webmaster: Stine Theede stine_theede@yahoo.com |


| APPLICATION FOR MEMBERSHIP PIONEER CAVY FANCIERS |