GREAT LAKES ZEBRA & SOCIETY FINCH CLUB
MEMBERSHIP APPLICATION

Dues: $10.00 per year 
(Yearly Membership runs Jan thru Dec & includes access to the Yahoo Online Group)
* required information

* Date: (m/dd/yyyy)

                                           * Name:
                                        * Address:
                   * City:     * State:    * Zip Code:

             * Phone: -    * Email Contact:  
 

All Checks & Money Orders need to be made out to Bob Peers
Check           Money Order           PayPal
(Email Address for PayPal Membership Payments: TielNMore@aol.com)
(You must complete & mail form even if you use PayPal)

*Mail Completed Form to:
Bob Peers
Attn: GLZSF Membership
1412 Spruce lane
Westmont, IL 60559

Office Use Only - Do Not Write in Boxes Below
Date Received: Initials:
Check   Money Order   PayPal