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ADDRESS INFO
Membership Type *	1-year Membership ($15.00) 2-year Membership ($30.00) 3-year Membership ($45.00)
Payment System *	PayPal secure credit card payment
Your Name * Your First & Last name
Your E-Mail Address * A confirmation email will be sent to you at this address
Choose a Login Name (User ID) * It must be 4 or more characters in length and may only contain small letters, numbers, and the underscore '_'
Choose a Password * Must be 4 or more characters
Confirm your password * Enter password again
Enter Verification Text * Please type text from image
Nickname * as it should appear on your member ID card
Birthday * MM/DD/YYYY
Phone (xxx) xxx-xxxx
Directory * Would you like your information published in our directory?	Yes No
Newsletter * In what form would you like to receive the Newsletter "Paw Prints"?	Hardcopy Email
Comment Additional comment(s)
Country*
State*
City*
Street*
ZIP*