Northwest Holland Lop Rabbit Club
Membership Application



Name(s):  ___________________________________________________

Mailing Address:  _____________________________________________

City, State & Zip:  ____________________________________________

Phone Number:  _____________________________________________

Email:  _____________________________________________________

New Member: ____    Renewal:  ____   Adult:  ____   Youth:  ____

ARBA Numbers:  ____________________________________________

Youth Member Birthdate:  ___________________________________

Rabbitry Name:  _____________________________________________

Website URL:  ______________________________________________

Dues:  $7.00/Single Adult per year
$12.00/Family per year
$4.00/Youth per year

Please make check payable to the:  NWHLRC

Mail to the Secretary::
Zina Helmandollar
18115 NE 205th Circle
Battle Ground, WA  98604
Hosted by www.Geocities.ws

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