Membership Form

Membership Form

Many thanks for being here. Your help is extremely important for our animals. Please fill in this form to become an APAP member.
Name*

First NameSecond Name
Address*

Address

Apartament, suite, etc.

CityProvince

Postal CodeCountry
Phone number*
E-mail*
Please choose which kind of member you'd like to be:*
prevnext( X )
"Chihuahua" Member
€5.00 for each month



"Cocker Spaniel" Member
€10.00 for each month



"Golden Retriever" Member
€15.00 for each month



"Saint Bernard" Member
€20.00 for each month
Signature*

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Date*

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Date
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