|
|
|
|
 |
 |
|
|
|
|
|
|
|
|
|
Sheri Daar, Treasurer
750 Woodlands Terrace
Lake City Florida 32055
2009 MEMBERSHIP APPLICIATION
NORTH CENTRAL FLORIDA PIGEON FANCIERS ASSOCIATION
NAME (s):____________________________________________________
_____________________________________________________________
If Junior, Please also list Parents’ name)
Junior Age:________________
_____________________________________________________________
ADDRESS:___________________________________________________
City________________________________________________________
State_________________________ Zip Code_______________________
PHONE NUMBER:____________________________________________
_____________________________________________________________
CELL PHONE:________________________________________________
EMAIL:______________________________________________________
_____________________________________________________________
Referred by___________________________________________________
BREEDS YOU RAISE:________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Make checks to N.C.F.P.F.A.
ADULT - $10.00 CASH $_______
FAMILY - $18.00 (2 Adults+ Children)
CHECK # ______
JUNIOR - $5.00 (Scholarship Available) Date Received _____
YEARLY
Database _____
Card _____
