For Office Use only
New Member________Renewal____________
Paid: $_____Cash___Check____Charge_____
Date___________________________________
American Cichlid Association
Membership Application
Date:________________________
Your Name:_______________________________________________________________________________________________
City:____________________________State:___________Zip/Postal
Code:______________ Country:_____________________
Would you like the above address
included if there were to be an online and printed ACA Membership Roster? Yes:________No:__________
Phone:
(Day):_________________________(Evening):__________________________Prefer
Day:_________Eve:___________
Would you
like the above phone number(s) included if there were to be an online and
printed ACA Membership Roster?
Yes:(D)__________(E)_________No:(D)__________(E)__________
E-mail:___________________________________________________
Would you
like the above e-mail address included if there were to be an online and
printed ACA Membership Roster?
Yes:________No:________
Have you
been an ACA member previously? Yes:__________No:___________Approximate
Date:_______________________
Local Club
Affiliations:______________________________________________________________________________________
National Club
Affiliations:___________________________________________________________________________________
Which do you
consider your “home” club?:_____________________________________________________________________
Specific
areas of cichlid interests (for example: South American;
__________________________________________________________________________________________________________
How
many tanks do you presently keep?_________________Ranging in size from___________________to________________
Approximately
how many total gallons?________________________________________________________________________
Would
you like to become involved in the ACA as a volunteer?____________________________________________________
Do you
enjoy writing about your cichlids?______________________________________________________________________
ACA Membership Dues (Please check one):
1 Year.....$25.00_______2 Years.....$50.00_______3
Years.....$70.00_______10 Years.....$230.00________
Junior Membership
(Under 18)
1 Year.....$15.00_______
1 Year.....$35.00_______2 Years.....$70.00_______3
Years.....$100.00_______10 Years.....$330.00_______
All other
Countries
1 Year.....$45.00_______2 Years.....$90.00_______3
Years.....$130.00_______10 Years.....$430.00_______
***NON-MEMBER*** SUBSCRIPTION
TO BB 1 Year.....$30.00_______________________________
Please Send your Membership Dues to:
Marty Ruthkosky, ACA Membership Chair
*You may find it most convenient and
expeditious to join or renew online at www.cichlid.org.*
Should
you have any questions about the ACA, or your Membership, please contact
Claudia Dickinson, your ACA Membership Coordinator, by e-mail: ivyrose@optonline.net, or by writing
to:
“Dedicated to the Conservation &
Dissemination of Knowledge of the Family Cichlidae.”
011708