Please provide the following contact information:

 Would you like to receive the club's newsletter by
 e-mail? Yes  No

Do you wish to be listed in the club directory?  Yes No

I am (please check all that apply)
Pet Owner Breeder Hobbyist Exhibitor 

Would you be willing to volunteer on a committee?
Yes No Future

If yes which committee?

Outreach Advertising Clean-up Fundraising

Refreshment Research for Newsletters

Welcome Table

What type of birds do you own or raise?