NPLC Membership Annual
Dues for 2010 Report and Directory


 

Annual Membership IF postmarked by MARCH 1, 2010 .....$175.00


$50.00 LATE FEE IF postmarked AFTER March 1, 2010 .......$225.00


    Download the PDF Form



NAME and ADDRESS of ORGANIZATION:

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PHONE:________________________
FAX:___________________________

E-MAIL:_________________________________________________________
WEB SITE:______________________________________________________


PRIMARY OFFICER:_____________________________________________


TITLE:_______________________________________________________


PRIMARY OFFICER’S E-MAIL__________________________________


PRESIDENT’S NAME__________________________________________


ADDRESS____________________________________________________


DATA: (FROM YOUR MOST RECENT YEAR)


                   REGISTRATIONS      ____________________


                   TRANSFERS               ____________________


                   ACTIVE MEMBERS   ____________________


LEADING STATES IN REGISTRATIONS


                   1.       ___________________________


                   2.       ___________________________


                   3.       ___________________________


                   4.       ___________________________


                   5.       ___________________________


NAMES AND ADDRESSES OF OFFICIAL BREED PUBLICATIONS:


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CIRCULATION__________


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CIRCULATION__________

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CIRCULATION__________

 




RETURN BY TO:


ZANE AKINS, TREASURER
177 PALERMO PLACE
THE VILLAGES, FL 32159-0094

TEL: 352-259-6005    FAX: 352-259-6005 (NOTE: IF YOU FAX YOU MUST CALL FIRST)

Email: zaneakins@gmail.com


Latest update: March, 1 2010