- Membership Form

Membership Membership Form

Become a member today! Print this page, fill-in the blanks, and return it with your check or credit card information to:
Parrot Education & Adoption Center
P.O. Box 600423
San Diego, CA 92160
Fax: (909) 563-8418
In return, you will receive:
  • E-mail subscription to our quarterly newsletter “Beak to Tail”
  • FREE admission to seminars with advance registration
  • Discounted admission to upcoming seminars and events
  • Discounts on purchases from selected parrot supply companies
Full Name:
Mailing Address:
City, State, ZIP, Country:
Phone and e-mail:
I heard about PEAC from:
Credit card type: [  ] VISA       [  ] Mastercard       [  ] American Express     [  ] Discover
Credit card number & CVV (located on the back of your card):
Expiration date (MM/YYYY) and Signature:
Membership type: [  ] $20.00 Individual
[  ] $30.00 Family
[  ] $75.00 Supporting
[  ] $100.00 Sustaining [  ]$1000 Lifetime

[  ] Additional donation: $

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