ORGANIZATION NAME _____________________________________________________________________
MAILING ADDRESS _____________________________________________________________________
_____________________________________________________________________
Physical Address
If different than mailing _____________________________________________________________________
Website _____________________________________________________________________
Business Phone _______________________________ Fax ________________________________
Cell Phone _______________________________
Email address _____________________________________________________________________
What is the name of your organizations contact person regarding Training seminars, MACA membership info etc.?
NAME: _____________________________________ PHONE _________________
EMAIL _____________________________________
MAILING ADDRESS ____________________________________________________
Years in Operation _____________ Are you a Private Rescue Group _______________________________
What type of Training offered by MACA would benefit your organization (i.e. Disaster Preparation, Grant witting,
Animal Control Officer, Facility Reorganization/Remodeling etc)
_________________________________________________________________________________________
_________________________________________________________________________________________
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Tear and keep the information below for your records
P.O.B. 202 Corvallis, MT 59828
www.montanaanimalcareassociation.org
Montana Animal Care Association (MACA) 2008 membership dues mailed on _________________
Check number ______________ Amount ____________
MEMBERSHIP IS CURRENT UNTIL JANUARY 2009.
