Name:  (Mr/Mrs/Ms)   First  ______________________________  Middle Initial ____  Last _____________________________________

Telephone Number:  Home:  _____________________  Cell: _____________________ Fax: _______________________

E-mail Address: ______________________________________  Website URL: _________________________________

I currently own _____ RagaMuffin(s).  Their names are:  _____________________________________________________

I acquired my RagaMuffin(s) from:  _____________________________________________________________________

Information in this section is requested, but optional:

Spouse/Partner’s Name:  ________________________________________   Birthdate:   _____________________________   

Children’s Names and ages: __________________________________________________________________________

Occupation:  _______________________________________  Hobbies: ______________________________________  

Application is being made for the following: (Check as applicable)

q       Regular Breeder Member (Must have completed Apprentice Requirements)............ $50.00/year

q       Apprentice Breeder: (Entry Level Membership)................................................... $50.00/year

q       Owner/Fancier Member................................................................................. $25.00/year

q       Family Membership........................................................................................ $10.00/year

Family Member: ___________________________________________________________________________________ 

                                        First                          Initial                                          Last                                        Relationship

The Membership Year runs from January 1 to December 31.  Dues are prorated monthly after June 30.  Prorated dues paid in conjunction with the following year’s membership fee, will entitle the member to one month free membership. Family Memberships are not eligible to be prorated. 

Please mail completed application and appropriate dues to:

Stephanie Newberry 65432 Avenida Dorado, Desert Hot Springs, CA 92240

Signature of Applicant: __________________________  Date:  __________________

Please make check payable to RAG.    Amt Enclosed:  ________   Check No.: ________

Payment may also be made through PayPal to E-mail Addy:  RagaMuffinGroup@gmail.com

THIS SECTION MUST BE COMPLETED IF APPLYING FOR BREEDER MEMBERSHIP

(If an Owner/Fancier Member is a member of any of the registries,  please complete as applicable)

Cattery Name (if chosen)   ____________________________

ACFA Cattery Number (if assigned):  ___________________

Cattery Registration Number for other associations:  _____________________________
I am currently a member of or have applied for membership in the following:

(membership in ACFA is required of all RAG Breeder Members)

AACE _________  ACFA _________ CFF _________ TICA _______UFO ________

CFA RagaMuffin Breed Committee __________

Note:  If you have not received membership and/or cattery registration numbers as yet, please indicate “Applied For” and supply them as soon as they are received.

Breeder Members must sign the Code of Ethics and include with Membership Application.