Michigan Aviculture Protectors Society Application

First Name:	Last Name:
Address:
City:
State:
Zip Code:
Phone Number: ( )
E-Mail:

Age of junior member:

Membership Category: _____________________________

Dues: $________

I would be willing to help with:

Meetings_____; Newsletter_____; Publicity_____;

Guest Speakers_____; Bird Show_____; 

Other____________________________________;

Please include amount listed for membership requested

Yearly Membership

• Junior Membership (16 and under) $10.00
• Single (Senior Membership 60+) $12.50
• Single Membership $15.00
• Family (Immediate-Living With) $20.00
• Family (Up to 3-including not living with) $25.00

Amount Enclosed: $___________

Membership year is September 1 through August 31.
Individual and Household members joining in February, March,
or April may pay the half-year rate. A full year's dues
received after April 30 will be applied to the next
membership year.

Mail your completed application
with your check payable to

Michigan Aviculture Protectors Society

To

Shannon A. Antor
Membership
1065 Olin Lakes Drive
Sparta, MI. 49345