AFRMA Membership Application Form

American Fancy Rat and Mouse Association

MEMBERSHIP APPLICATION FORM

This application is required along with payment.

This on-line application form is only to be used when using PayPal to pay the membership dues

Do not press the ENTER or RETURN key!

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 #: E-mail address*:

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)*:

U.S.A. Residents ($26.06)
Canada ($31.53)
Overseas [U.K., Europe, Australia, etc.] ($36.73)

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 have?
RATS: Pets Breeding Show/Fancy
List Colors/Markings/Coat types if you breed

MICE: Pets Breeding Show/Fancy
List Colors/Markings/Coat types if you breed

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.

Updated March 6, 2011

© 1995–2013 American Fancy Rat and Mouse Association.
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Unauthorized copying of any part constitutes a breach of copyright law.