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New Membership
DATE: 13.12.2010
Individual
New Member
Corporate
(For Commercial Traders Only)
Returning Member
* Required Fields
Family Name
*
Given Name
*
Middle Name
*
UserName
Password
Confirm Password
Gender
Male
Female
Age
Birthday
Marital Status
Single
Married
Number of Children
Address
Telephone
Cellphone
Email
Name of School/Company
Office Address
Occupation
Office Telephone
ABOUT YOUR FISH
Years in Fishkeeping
*
In Discus
PLEASE ANSWER THE FOLLOWING QUESTIONS
Most Visited Fish Store (LFS)
Do you own a LFS, import, breed or sell any fish/products? Where and what kind?
Are you willing to volunteer for a committee? If yes, please put an (x) mark on the committee that you maybe interested in joining.
[ ] Membership & Election [ ] Special Awards [ ] Fish Show [ ] Special Events & Projects [ ] Fund Raising [ ] Newsletter [ ] Website
As a member, how can you contribute to PDS?
Do you know any existing members? If yes, please name at least two.
I hearby certify that the information contained in this application form is true. I understand that my falsification of information may result in my failure to be a member of PDS. I also agree to abide by PDS's by-laws and rules and regulations set by PDS.
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