This page was last updated on: November 20, 2008

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Florida Budgerigar Society.

  Membership Application.

Membership Chairman:

Diane Stanton:      cyberick@cfl.rr.com

Date:

Phone:

E-Mail:

New:

Renewal:

Name:

Birthday:

2nd name for family membership:

Birthday:

*

*

Address:

City:

State:

Zip:

E-Mail:

Website:

$   5.00

$ 10.00

$ 15.00

1 Vote.

2 Vote.

1 Vote.

JuniorMembership(apart from family up to16yrs)

Single Membership:

Family  Membership:

List Colour and Varieties you Breed:

Skills you are willing to share:

How did you hear about F.B.S.;

Referred By:

A.B.S. Membership Code:

BandCode:

Please list where you can assist our Club:

Hosptitality:

Publicity:

Library:

Raffle:

Show:

Newsletter:

F.B.S Office use only Please:

NewsletterBusiness Card Ad:

Member:$5.00 per year.

NonMember:$20.00 per year.

F.B.S. is an American Budgerigar Society Afflitiate. [Pending]

Please feel free to copy Application and mail to:

Florida Budgerigar Society. 1567 Manzanita Street NW. Palm Bay,FL 32907

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Date:

Other:

Members Name:

Membership Type:

Received By:

Cash: $

Check: $

Check: #

Receipt:

Club Dues----One Year Membership Runs From June 1st through May 31st