Name:

Address:

Phone:

Do you want to receive your newsletter by email?    ¨ Yes          ¨ No

Email Address:

Additional Family Members: (include youth birth dates)

Name

ARBA #

Birth Date

Type of Membership:

New

Renewal

Single Adult $8.00

Husband/Wife $10.00

Single Youth $8.00

Family: $12.50 (Same Address)

Birth Date:

Foreign $20.00

Recommended by:

Make check payable to American Polish Rabbit Club and send to:     Patti Walthrop     APRC Secretary/Treasurer     2405 Greenridge Ct.     Euless, TX  76039