Application is hereby made for membership in the Santa Clara Valley Canary and Exotic Bird Club. Enclosed is $25.00 for the present year, or $12.50 if joining between July and October and have never been a member. Those joining in November or December will be considered paid through the following year. Junior membership for those under 16 is half price.

Type of membership (check one)

• Regular for 1 year ($25)
• First time member for ½ year, July-October ($12.50)
• Junior for 1 year ($12.50)
• First time Junior for ½ year, July-October ($6)

Name:____________________________________________________________
(List all members included in your membership)

Address:__________________________________________________________
(include City, State, Zip)

Telephone: (_____)_____________________

Date: _________________

email address:___________________________________________________
(used for sending occational club announcements only)

Make check payable to: SCVCEBC

Mail to:
SCVCEBC
P.O. Box 3466
Santa Clara, CA 95055-3466

Interests (optional, circle all that apply):

1. Canaries
2. Finches
3. Budgerigars
4. Cockatiels
5. Hookbills
6. General Collection