American Pet Products Association, Inc.
255 Glenville Road
Greenwich, CT 06831
Tel: (800) 452-1225 Fax: (203) 532-0551
APPLICATION FOR DOMESTIC LIVESTOCK MEMBERSHIP
APPA accepts into domestic membership livestock suppliers which breed/sell domesticated companion
animals in the following categories: bird, cat, dog, equine, fish, reptile, small animal. Livestock must be
intended for sale as companion animals at the retail level in the U.S. Membership applications are reviewed and
approved by the APPA Board based on these qualifications.
The undersigned hereby makes application for Domestic Livestock Membership in American Pet Products
Association, Inc. (APPA) and, if accepted for membership by the Board of Directors, agrees to abide by all the
rules, regulations and by-laws of said Association.
Directions: Please complete this form in its entirety by typing your response, or where appropriate, indicating
“Not Applicable”. Incomplete information or documentation will delay processing and consideration of this
application. The information contained in this application will remain confidential except to the extent
necessary for consideration of membership and/or provision of member services.
1. Company and Key Contact Information:
Firm Name:
Contact Name:
(Ms./Mrs./Miss/Mr.)
Address:
City:
State:
Zip/Postal Code:
Country:
Phone:
Fax:
E-mail Address:
Website:
(First)
(Last)
2. Please print the name(s) of any additional individual(s) you wish listed in the database in the positions
indicated below:
Name
-
Best Practices/EDI
Billing/Invoicing
CEO/President
Export Professional
Human Resources
Marketing Director
MIS
National Sales Manager
Nutritionist
Public Relations
Regulatory
Sales Manager
Sponsorship
Trade Show
Website Contact
Other (please specify)
Email
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Business Profile:
3. Name the applicant’s type of business entity:
□ Corporation
□ Partnership
□ Sole Proprietorship
4. Please indicate the type of companion animals you supply:
_____
_____
_____
_____
Bird
Cat
Dog
Equine
_____ Fish
_____ Reptile
_____ Small Animal
Please provide a copy of your pet brochure or advertisement indicating that you are a livestock supplier that
breeds/sells domesticated companion animals.
5. Are your domesticated companion animals being sold to U.S. retail pet shops or distributors?
______ Yes
_____
No
Please submit one (1) invoice showing the sale of your animals to a U.S. retail pet shop or distributor along
with a matching bill of lading showing the shipment of the companion animals from your facility.
6. What percentage of your pet product income is derived from:
a. Distribution of companion animals:
_______%
b. Breeding of companion animals:
_______%
c. Other:
_______%
If Other, please specify: _____________________________________________________________________
7. Do you have a breeding/kennel/cattery facility or distribution center in the U.S.:
__________ Yes
__________ No
Please enter the address of your facility:
Address: _________________________________________________________________________________
City: __________________________________________ State: __________________________________
8. Number of Employees:
Indicate the number of full-time employees in your company (employees in pet products division only).
Company information will remain strictly confidential.
_____ Less than 5
_____ 51 - 100
_____ 6 – 10
_____ 101 - 250
_____ 11 – 25
_____ 251 - 500
_____ 26 – 50
9. Pet Product Sales
As you evaluate your dues category, please indicate which category of total annual worldwide sales of domesticated
companion animals is applicable to your company. To ensure accuracy, have your CEO, CFO or certified public
accountant or other accounting officer verify the appropriate dues category for your company. Accurate reporting of
member dues is essential to the vibrancy of the Association. APPA reserves the right to conduct random dues level audits
at any time. Company sales information will remain strictly confidential.
_____
_____
_____
_____
_____
_____
_____
_____
_____
Worldwide
Gross Annual Sales (USD)
Under $500,000
Between $500,000 to $2,000,000
Between $2,000,000 to $5,000,000
Between $5,000,000 to $10,000,000
Between $10,000,000 to $15,000,000
Between $15,000,000 to $25,000,000
Between $25,000,000 to $50,000,000
Between $50,000,000 to $100,000,000
$100,000,000 +
Annual Dues (USD)
$670
$980
$1,900
$3,700
$6,000
$6,825
$8,150
$9,600
$13,250
You have checked ___________________ as your Gross Annual Worldwide Sales and _______________ as your Dues
Category.
10). I certify that the above information is correct as stated including the fact that my company’s annual sales of
domesticated companions for the last fiscal year were in the category indicated above. I understand that should this
information be incorrect, this application will be rejected. I further understand that if the application is accepted and later
discovered to be incorrect, my company’s membership will be terminated.
□ Yes
11). Membership applications withdrawn before presentation to APPA’s Board of Directors will be assessed a $75.00
processing fee. No credit or refund will be issued for the withdrawal of a membership application after the Board’s
approval, regardless of reason.
Please note: I understand that if I reserve a booth for Global Pet Expo subsequent to my membership approval,
that booth availability and location are not guaranteed. Booth availability is subject to inventory at the time of
receipt of my booth application and all booths are assigned on a first-come, first-served basis.
Name: ____________________________________________ Title: _________________________________________
Company: _________________________________________ Signature: ____________________________________
Date: _____________________________________________ As an Officer of: _______________________________
American Pet Products Association, Inc.
Application Checklist
Items must be submitted in their entirety for application review and approval. Incomplete submission will cause a delay
in the membership approval process. Please submit by email, mail or fax.
□
Application signed by an officer of the applicant. (Items left blank or unclear constitute an incomplete
application which cannot be considered.)
□
Please provide a copy of your pet brochure or advertisement indicating that you are a livestock supplier
that breeds/sells domesticated companion animals as indicated in item #4 of this application.
□
Please submit one (1) invoice showing the sale of your animals to a U.S. retail pet shop or distributor along
with a matching bill of lading showing the shipment of the companion animals from your facility.
□
Payment in U.S. dollars either by check or credit card for the joining fee ($1,000) plus first year’s dues
based on the annual worldwide sales of your domesticated companion animals (as indicated in item #9
of this application).
Contributions or gifts to APPA are not tax deductible as charitable contributions for federal income tax
purposes. However, they may be deductible as ordinary and necessary business expenses subject to
restrictions imposed as a result of APPA’s “lobbying” activities as defined by the Budget Reconciliation
act of 1993. APPA estimates that the non-deductible portion of your dues – the portion that is allocable
to “lobbying” – is 20%.
APPA Membership Dept.
255 Glenville Road
Greenwich, CT 06831
Copyright © 1998-2014 American Pet Products Association, Inc.
APPA and American Pet Products Association, Inc. are registered trademarks of the American Pet Products Association,
Inc. All rights reserved. Important Note: See the APPA Web Site Agreement of Use.
APPA MEMBERSHIP DUES PAYMENT FORM
Please indicate below the method of payment for your 2016 initiation fee/dues payment of $_________________________
(If the amount is not indicated above, you will be charged a $1,000.00 joining fee and the dues amount stipulated on your
membership application form.)
1)
_____
Check or money order (must be in U.S. funds drawn on a U.S. bank and made payable to APPA.)
2)
_____
We will pay by wire transfer, please email wire transfer information to:________________________________
3)
_____
MasterCard
_____
Visa
_____ American Express
________ Discover
____________________________________________________________________________________________________
Account Number
CVV Code
____________________________________________________________________________________________________
Expiration Date (MM/YY)
____________________________________________________________________________________________________
Cardholder’s Signature*
*By signing here, you authorize APPA to charge the amount indicated above to your credit card account.
Company:
_________________________________________________________________________________________
Address:
_________________________________________________________________________________________
_________________________________________________________________________________________
City:
________________________________________
Province: ______________________________________
State:
____________ Country: ___________________________
Phone:
________________________________________
Email:
_________________________________________________________________________________________
Zip/Postal Code: _______________________
Fax: __________________________________________
Please list a credit card billing address if different from above:
Address:
_________________________________________________________________________________________
City:
________________________________________
State:
___________ Country: _____________________________ Zip/Postal Code: ________________________
Province: ______________________________________