GREAT LAKES TAN SPECIALTY CLUB

MEMBERSHIP APPLICATION New PLEASE PRINT Name: Date of Birth: Phone: ARBA # Email Renewal Youth $5 Single $7 Couple $12 Family $12 +$2 ea. person

Current address:

City:

State:

ZIP Code:

ADDITIONAL ADULT MEMBERSHIPS Name: Date of birth: Name: Date of birth: Phone YOUTH MEMBERSHIP Name Name Name DOB DOB DOB ARBA # ARBA # ARBA # Phone ARBA# Email ARBA# Email

Permission to post minor(s)s name and photo on website? ______yes _______no RABBITRY NAME:

List on website? ________yes _______no

What to list:

I hereby apply for membership to the Great Lakes Tan Specialty Club; a National Specialty Club chartered by the American Rabbit Breeders Association and I have enclosed fees for the above marked memberships. I agree if accepted to abide by the Constitution and By-Laws, and further the interest of the Tan Rabbit in every way possible.

Money orders are the preferred method of payment.

Official GLTSC Use Only Date join ________________ Cash __________ __________________ Date Expires ______________

THERE WILL BE A $25.00 FEE FOR ALL RETURNED CHECKS!!!!

PLEASE RETURN COMPLETED FORM AND FEES TO: GLTSC 4636 Piersonville Rd Columbiaivlle, MI 48421 gltsc@yahoo.com

Membership card sent: _________________ Amount

Check # ____________

MO # _______________