2010 Missouri Earthdogs Membership Form
 

Memberships are valid for one Jan-Dec calendar year
(Memberships purchased in Oct Nov Dec will be honored for the current and following year)
Check One: __ Family/Couple $20  __ Individual $15   __ Youth (18 or younger)$10 
 

Name

Address

City

State/Zip

Phone                                                                        Phone

Email

What breed of earthdog do you own?

I would like to receive my newsletter by (check one) : __ snail mail (USPS) or __ email

Make your check payable to: Missouri Earthdogs

Mail form and check to:

Shirley LaMear
8767 John McKeever Rd
Pacific, MO 63069