PNPA Membership Application 2009-2010

Name_________________________________________________
Mailing Address_________________________________________
                         _________________________________________
Phone #___________________ Fax #_______________________
Email_________________________________________________
How would you prefer to receive information____________________
Are you a (indicate all categories that apply to you)
Producer:
             poultry
             eggs
             turkeys
             game birds
             rabbits
             other (that may be significant)
Consumer:
             poultry
             eggs
             turkeys
             game birds
             rabbits
Do you have any special skills that you would be willing to donate to this association? _______________________________________________________________________________________
_______________________________________________________________________________________
Do you have any particular concerns that you think we should address?
_______________________________________________________________________________________
_______________________________________________________________________________________

Information given on this application will not be released to any other person or organization without the express permission of the applicant.
Please indicate any of the above that you want to be made available on our web site or other PNPA information bulletins
______________________________________________________________________________________

Contact for information: Megan D’Arcy (250) 847-8832, Anita Trenerry (250) 877-1745 or Alfred Horning (250) 698-7692
web-site: www.pnpa.ca
Mailing address: 20535 Kitseguecla Loop Road, Smithers, B.C., V0J 2N1

Yearly membership fee: $20
payable to: Pacific Northwest Poultry Association