EmailMeForm
2021 GOCBS Membership Form
Please choose your membership and pay here.
New or Renewal
*
Please select
New
Renewal
Date
*
MM
/
DD
/
YYYY
Primary Name
*
First
Last
Primary Email
*
Primary Phone
*
###
-
###
-
####
Primary Phone Roster
*
Please select
Yes
No
Secondary Name
First
Last
Secondary Email
Secondary Phone
###
-
###
-
####
Secondary Phone Roster
Please select
Yes
No
Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Type of Membership
*
Please select
Junior Jan-Dec $12.50
Junior July-Dec 6.25
Single Jan-Dec $20.00
Single July-Dec $10.00
Family Jan-Dec $25.00
Family July-Dec $12.50
Business Assoc Jan-Dec $25.00
Business Assoc July-Dec $12.50
Please note that Junior Membership is 16 or under.
Birthdates
Please list first name(s) and birthdate(s) (month and day only). If you have children that would like to see their birthdate announced you can list them here too.
Pet Birds
Do you breed birds?
Please select
Yes
No
Are you interested in fostering?
Please select
Yes
No
Quarantine area available?
Please select
Yes
No
Comments
