Membershipform

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Asian Gamefowl Society of America and Canada


O NAME


O ADRESS


O ZIP / POSTAL CODE


O CITY

O STATE

O COUNTRY (USA - CANADA)


O TELEPHONE


O MOBILE PHONE


O FAX


O BREEDS LARGE


O BREEDS BANTAM

Please tick boxes for the information being displayed in the AGS memberlist. Mandatory data (name, state, country, gamefowl breeds and telephone/mobile nr, email address). Incase the address is not ticked - your address data is only only used for postal purposes.


Membershipfee = 25,- USD or Canadian Dollars (membership includes yearbook + detailled memberlist)

Ways of Payment

Accepted forms of payment : personal check, cash, money order (make payable to Charles Cartwright) or Paypal https://www.paypal.com/ once on PayPal click on "Send Money-online" and follow the instruction. Use this e-mail address rezaranch@hotmail.com to direct funds to my account.

Send Membershipform to

Chad Cartwright (AGS contact)
1125 N Oak Park Dr
Springfield,Mo 65802
417-866-5934 - United States

email rezaranch@sbcglobal.net

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