Membership Form with Sofort

HIGH TIDE HOLLANDS

Holland Lop Specialty Club Membership Form
Membership Type

New MembershipRenewal
Membership Options

One Year Membership- $10.00Family Membership- $15.00
Would you like your rabbitry to be listed in the newsletter directory?

Yes- I will send the additional $5.00No
Name(s):

First NameLast Name
First NameLast Name
First NameLast Name
First NameLast Name
ARBA #(s)
Rabbitry Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Membership applications will not be approved until payment is received.
Please send membership fees via Paypal

Paypal:

Hightidehollands@gmail.com

Please email Hightidehollands@gmail.com if you have any questions or concerns regarding this application.
I herby agree that my information on the application for membership will be stored within the High Tide Hollands club and agree to abide by the clubs constitution and bylaws.
Signature

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HIGH TIDE HOLLANDS