International Indian Dog Owners & Breeders Association Membership Form

FULL MEMBERSHIP
Includes husband, wife & children under 18 years.

$25.00
 

AFICIONADO MEMBERSHIP
May include same family members as above.

$20.00

 
Member's name:
American Indian Dog(s) name:

Registration #(s)

Address:
City, State:
Zip Code:
Phone/Fax:
Email or Web Address:

Note: Membership is to be paid on or before January 1st of each year. Those members who join after October 1 will be automatically extended through the next year.

Number of People in this membership.

_______ Juniors _______ Adults

Junior names and birthdates (optional)

___________________________

___________________________

Please check your interests below:
Please answer the following questions:
Training/obedience  

Native American Pow Wows

 
Fund raising  
Therapy/Service Dog work  
Promotion/Merchandising  
Research/Education  
Exhibitions  
Newsletter Contributor  
Committees  

If not already an owner, do you plan to purchase an AID in the future? __________________________

If so, when? __________________________

How many other dogs do you own? __________________________

__________________________

Enclosed is my check for $ _________ in US
Funds made payable to the IIDOBA
Note: There will be a $20.00 processing fee on any returned checks

Other organizations (animal related that I am a member of:

_________________________

_________________________

_________________________

_________________________

Send to:

Kim LaFlamme
3600 Lakeshore Drive
Selma, Oregon 97538
(541) 597-2871
laflamme@earthlink.net

___/___/___
IIDOBA use only

Interviewed by:
____________
____________

Or you may use this Word text document - Plain text file here!
Mac Word document here.

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