MBGBA Membership, 9462 Clay Rd., Traverse City, MI 49684
First Name(s)________________________ Last
Name___________________________
Business
Name__________________________________________________________
Street Address or P.O.
Box_________________________________________________
City__________________________________ State_____ Zip
Code________________
Phone (______)___________________ E-Mail
Address__________________________
Web site URL:______________________________
Dues: Single or Family Membership $15/year (same mailing address)
Please do not send cash through the mail. Make payments in check
or money order payable to: MBGBA
Please list the names of the birds/game you raise. If you require
additional space for listing,
feel free to attach additional pages.
Pheasants:___________________________________________________________________________
Peafowl:____________________________________________________________________________
Poultry:_____________________________________________________________________________
Turkey:_____________________________________________________________________________
Waterfowl:__________________________________________________________________________
Partridge:___________________________________________________________________________
Pigeons:____________________________________________________________________________
Quail:______________________________________________________________________________
Cage
Birds:_________________________________________________________________________
Ratites:_____________________________________________________________________________
Other:______________________________________________________________________________