Birman Cat Club of New Zealand
(Incorporated)
113 Hautapu Road, R.D. 1, Cambridge 3493
maxi.addi@clear.net.nz
www.birmancatclub.co.nz
Membership Application Form
Name(s):
Address:
Phone number:
Home:
Work:
Cell number:
Home:
Work:
Fax number:
Home:
Work:
Email address:
Website Address:
Breeding Prefix:
Birman cats or kittens owned
Please tick a box below to indicate status of your cats
_______________________________________________ Stud
Sire _______________________________________________
Dam _______________________________________________
Queen
Neuter
Spay
_______________________________________________
Sire _______________________________________________
Dam _______________________________________________
Queen
Neuter
Spay
Name
Name
Stud
Name of the Breeder of your Birman (s):


Signed
I/We consent to be bound by and submit to the rules of the Birman Cat Club of New Zealand (Inc).
The above information is supplied only for the record keeping purposes of the Birman Cat Club of New Zealand Inc:
_________________________________________
Date
____________________
Membership Type
New Zealand Single Member
New Zealand Joint or Family Members
International Single Member
International Joint or Family Member
Fee
$20.00
$30.00
$25.00 NZD
$35.00 NZD
Total Amount Enclosed
$
Annual Membership fees are due on the 1st October each year
Cheques made payable to the Birman Cat Club of NZ
Please mail to:
The Secretary
Birman Cat Club of NZ (Inc)
Maxine Jorgensen
113 Hautapu Road, R.D.1
Cambridge 3493
Office use only
Application approved:
President:
Secretary:
Date:
Amount Paid: $