United Gloster Breeders
Membership Application for 2010

(Membership runs 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:________________________

Email Address:_________________________________
=============================================
PLEASE NOTE: 
1.) When Requesting Bands for 2010: (Please remember to add $2.00 for packaging & postage)
2.) Bands are .28cents each and sold in sets of 25 only  ($7.50 for a set)
3.) You must be a member of UGB to purchase bands

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

================================

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 2010 for $10.00
             This is a good way to show support for the club.

=====================================================
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

 

Web design by Starbird FlyingHi Designs. Copyright©2003 Starbird FlyingHi Designs and Barbara Rosario. All rights reserved.