PPGAM MEMBERSHIP APPLICATION FORM

PPGAM MEMBERSHIP APPLICATION FORM (Online Application/Membership Form)

Date:                                    Member Since:              (year)   I Groom: cats __ dogs __ other __

Name:                                              Phone (Home):                   Phone (Cell):

Email:                                      Website:

Address:                                                                                Phone (Work):

City:                                       Province:                             Postal Code:

Business Name:                                                         Phone:                    Fax:

Service(s) Offered:       Shop:        Mobile:       Both:

City:                                       Province:                             Postal Code:

___ Annual Membership: $100/year (November 2011 - October 2012)

includes Accident Insurance

Annual Membership: $100/year (November 2012 - October 2013)

includes Accident Insurance

Annual Membership: $100/year (November 2013 - October 2014)

includes Accident Insurance

Annual Membership: $100/year (November 2014 - October 2015)

includes Accident Insurance

( ___ Yes, I would like to receive my Newsletter via email.)

__ I give permission for the PPGAM to provide my information as stated above to other members
within the association on any official PPGAM marketing material.

Signature (in ink)

Online Application/Membership Form

Please make Cheque Payable to P.P.G.A.M.

Mail To:
PPGAM Treasurer
381 Arnold Avenue
Winnipeg, MB. R3L 0W8

Or Pay Via PayPal

Click PPGAM Logo To Pay Using PayPal

C L A S S I F I E D S E C T I O N