This online application form is only to be used when using PayPal to pay for the Membership dues/Breeder’s Listing
Fields with a * are required fields.
Date (mm/dd/yyyy)*:
Name(s)*: Address 1*: Address 2: City*: State*: Zip*: Country (if not U.S.A): :
Telephone #: Include Telephone # on Breeder listing? Y N
E-mail address*: Include E-mail on Breeder listing?* Y N
Rattery/Mousery Name (include prefix initials–up to 4 characters):
Web Site Address:
Membership Type (Individual or Family in same household; all amounts in U.S. Dollars) (includes Breeder’s Listing fee)*:
If Family, enter Total # (include all family member names above)
Member*: New Renewal
Would you like your newsletters*: Online (full color PDF) or Mailed (B/W version)
Would you like the AFRMA Show Regulations & Standards Book?*: Y N
Age(s), if under 18:
If under 18, parent name:
What do you breed?
RATS: Pets Breeding Show/Fancy RATS: American Pure English Standard Rex Tailless Hairless Satin Dumbo Other Markings Colors
MICE: Pets Breeding Show/Fancy MICE: Pure English English/American American Standard Satin Long Hair Long Hair Satin Frizzie Frizzie Satin Hairless Other Markings Colors
Do you Ship? Y N Conditions:
Additional Breeder Listing Comments:
You may include a photo with your ad. Send digital photo (JPG, GIF, PNG, or TIF only) to: breedlist@afrma.org
May we refer people to you*? Y N
Do you plan on participating in So. California Shows*? Y N
How did you hear about AFRMA?
Additional Comments (optional):
In making this application for membership to the American Fancy Rat and Mouse Association, I/we agree to, if accepted into membership by the Board of Directors, abide by and be bound by the rules set by the Association.
In lieu of a signature, the submission of this form and payment of annual dues is an agreement to the terms of membership.
Before sending this form, you should print it for your records. After you press SEND, you should get a screen thanking you for sending your application and a “Buy Now” button to pay via PayPal.
If you do not get the “Thank You” screen, then your e-mail didn’t go through and you will need to copy this page and paste into a regular e-mail and send it to membership@afrma.org, then send your payment via PayPal.
