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United Gloster Breeders
Membership Application for 2008

(Membership running from Jan 1, to Dec 31,)

Dues:
Single Membership @ $20.00 a Year (U.S. funds)______
Duel Membership @ $25.00 a Year (U.S. funds) ______
Is this a Renewal _____ or New _____ Membership?

Name(s) Membership to be listed as:

Name(s):__________________________________________________________

Address: __________________________________________________________

City/State/Zip Code:________________________________________________

Area Code/Phone Number:________________________

E.Mail Address:_________________________________
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PLEASE NOTE: We are currently out of bands for 2008. 
Bands Request for 2008: (Please remember to add $2.00 for packaging & postage)

Bands are .25cents each and sold in sets of 25 only 

Number of bands requested ______    Total amount due on bands plus the $2.00 for shipping  $________

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United Gloster Breeder's National Catalog Ad
_____ Yes, I would like my name(s) place in the United Gloster Breeders National Catalog Ad for the year 2008 for $10.00
             This is a good way to show support for the club.

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Total amount due:$ ___________  (including membership, bands and ad space if indicated

Thank you for your support of United Gloster Breeders
Make checks or money orders payable to UGB
Remit to:
United Gloster Breeders
Barbara Rosario
715 Avocado Court
Del Mar, Ca 92014
pen email
You have any questions regarding
 United Gloster Breeders, 
please e-mail your questions

 

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