Membership Application
Ohio State New Zealand Rabbit Breeders Association
MEMBERSHIP APPLICATION
OHIO STATE NEW ZEALAND RABBIT BREEDERS ASSOCIATION
Dues:
Single - $8 yearly
Married Couple - $10 yearly
Family - $12 yearly
Newsletter (check one)
___ by email, no charge
___ by US mail, include additional $10 yearly
Make checks payable to: OSNZRBA
Name_______________________ Circle: Adult/Youth Youth Date of Birth ___________ARBA # ________________
Name_______________________ Circle: Adult/Youth Youth Date of Birth ___________ARBA # ________________
Name_______________________ Circle: Adult/Youth Youth Date of Birth ___________ARBA # ________________
Name_______________________ Circle: Adult/Youth Youth Date of Birth ___________ARBA # ________________
Name_______________________ Circle: Adult/Youth Youth Date of Birth ___________ARBA # ________________
Amount Paid: ______________________ Date: ___________________________ Cash/Check#______________
Contact Information:
First Name ____________________________________ Last Name ______________________________________
Address: __________________________________________________________________________________
__________________________________________________________________________________
Phone Number: _______________________________________________
Email: ________________________________________________________________________________________
Mail Form and Dues to: Amanda Hutcheson Questions: osnzrba@gmail.com or (330) 283-0709
278 Poplar Street
Pataskala, OH 43062
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Dues Receipt
First Name ___________________________________ Last Name _______________________________
Amount Paid: __________________________ Date: ______________________________
Club Secretary Signature: ________________________________________________________________