Membership Application

Day Month Year
Name
Street
City
State/Provence
Country
Zip/Country Code
Phone Fax
Email
Web Site http://
I sell doves: Yes No
You may publish my phone # in the ADA Membership Directory: Yes No
Membership: New Renewal
$25.00 Regular US membership

$25.00 International (subscription sent by email only no physical copy sent)
$21.00 Senior Citizen (60 years and older)
$15.00 Junior (17 years and younger)
$26.50 Family (husband/wife, father/son, etc., same address)

Please list which doves you keep in the box below. For Ringnecks & Diamonds please include colors.

This information will be listed in the breeder Directory unless you indicate otherwise.

If you are planning to mail in payment then please PRINT THIS FORM and send it with payment to:

Steve Truss , Membership Secretary
4500 West 700 S
Wabash, IN 46992-8229