APPC Membership ApplicationAmerican Pigmy Pouter ClubMEMBERSHIP APPLICATION Regular Membership(U.S.&Canadian)-$15.00* Family Membership(U.S.&Canadian)-$15.00* International Membership-$20.0 (* All Funds are in U.S. Currency) Please Make Checks Payable to "American Pigmy Pouter Club" ***************************************************** Name_______________________________________ Junior______ Senior________ Address_____________________________________ City_________________ State___________ Zip________ Phone________________ E-Mail___________________ Breeds/Colors Raised:____________________________ ________________________________________________ ________________________________________________ ________________________________________________ Other Club Affiliations:________________________ ________________________________________________ ************************************************* *Print and cut this page at the line above* *Send application to: Stanley Staveckis PO Box97 Clayton,NY 13624 spsbird@twcny.rr.com (315)686-2694
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