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| Membership Application |
Youth- 3 Year $14.50 Husband/Wife- 1 Year $11.50 Husband/Wife- 3 Year $29.50 Family- 1 Year $11.50 + 3.50 each Youth Foreign Membership- add $5 to each option Check one: New Member__________ Renewal_________ ARBA#_________________ Name:_________________________________________________________________ Address:________________________________________________________________ City: ____________________________________ST:______ Zip:___________________ Phone #:__________________________________ E-mail Address:___________________________________________________________ Rabbitry name (if applicable):________________________________________________ Reccomended By:_________________________________________________________ If Youth, please provide birth date: ____________________________________________ Please check an answer: I would like my information included in the Havana Rabbit Breeders Association Breeder Directory to be distributed to people interested in purchasing Havana rabbits: Yes:__________ No: _____________ Newsletter: How would you like to receive your newsletter? Mail:_____ E-mail: ______ Advertising option: I would like to place an ad in the Havana News. Full Page $65_______, 1/2 Page$40_______, 1/4 Page $30_______, or Business Card $10_______ Copy is: Enclosed_______ or Copy will be mailed to havanasecretary@yahoo,com_________ Please send application to: Tanya Zimmerman, HRBA N9487 Walnut Rd Clintonville, WI 54929 |
WON'T YOU JOIN US? |