SDCCC Membership Application Form

Membership Dues are US $30.00 per person (or family) for

one year. At the time you apply for membership you may also

place an order for closed leg bands for the current year. Please fill in the form below and then print it and mail along with your check for the appropriate amount to:

San Diego County Canary Club c/o Winnie Adams
P.O. Box 634
Campo, CA 91906


Name: ________________________________________________________________

Address: ______________________________________________________________

City, State, Postal Code: __________________________________________________

Phone: _____________E-Mail: _____________________________________________


(  ) New Member (  ) Renewal

New members who join anytime between the months of August through December are current until the following year.

Band Order (circle one):

25 - $15.00   50 - $30.00   75 - $45.00   100 - $60.00   150 - $90.00   200 - $120.00

Quantity Requested: __________ Amount enclosed $: _______________

You can get a two letter code or initials on your bands. If you would like initials on your bands, please list 2 choices of two letter combinations. We will try to give your first choice, but the initials cannot be repeated by more than one breeder so they will be assigned on a "First come" basis. We can only deliver coded bands on

orders placed before September 15.  Add $4.00 for S&H.


Two or three letter initials on bands: Choice 1: _____ Choice 2: _____ Choice 3:______

Signature: ____________________________________Date: ____________________