Rats PacNW Membership Application Form
Name: 1)_________________________________________________
2)___________________________________________________
3)___________________________________________________
4)___________________________________________________
5)___________________________________________________
6)___________________________________________________
Address: 1)__________________________________________________
___________________________________________________
___________________________________________________
Phone: __________________________
Email: _____________________
Membership type:___ $10.00 Individual Membership
___ $5.00 Junior Membership (12 and under - no voting privileges)
___ $17.50 - Family Membership - 13 and older (husband/wife, SO/SO, Parent/child, sibling/sibling);
$5 for each additional household member 13 years of age and older,
$2 for 12 and under (please indicate which family members are 12 and under if any)
Total Membership Fees: $____________
Please make check or money order payable to RatsPacNW and send form to:
RatsPacNW Membership Committee
c/o Renee White
8493 Spring Creek Road SE
Port Orchard, WA 98367