Address: _______________________________________
Address: _______________________________________
City: ______________ State:
_________ Zip: _________
Phone: ___________________
Email: ___________________
Rabbitry name: ________________________
ARBA #: _________________ APRC #: ______________
Open: ___________ Youth: ____________
Please circle your membership
selection:
Youth membership: 1 Year:
$3.00 3
Years: $7.00
Adult Membership:
1 Year $5.00 3
Years: $12.00
Joint Membership: 1
Year: $8.00 3
Years: $20.00
Family Membership: 1
Year: $10.00 3 Years: $25.00
Make Checks or Money Orders
payable to:
Please mail application to:
Caroline Gallo
1756 Main Street, Apt B,
Keeseville, NY 12944