Online Membership Form
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Northern Illinois Parrot Society

Online Membership Application

 Check One:
  New
  Renewal
Please fill out the form as completely as possible. Address, phone and email information are for club purposes only. No information will be distributed to outside individuals or companies without your prior permission.



First Name:  
Last Name:  
Street Address:  
Address (cont.):  
City:  
State:  
Zip Code:  
Home Phone:  
Cell Phone:  
Work Phone:  
Email Address:  

By completing this form I understand that NIPS allows individuals to bring their companion birds to meetings, but NIPS is in no way liable for any injuries or illnesses that may occur to the birds while at the meeting or any time afterward. It is recommended that birds brought to a meeting have a physical exam with an avian veterinarian within the past year. It is also recommended that all birds have their wings clipped if attending a meeting. NIPS cannot be held accountable for illness or injury to any bird or person.

NIPS Membership Categories
(Check One)
Fledgling Membership (12 & under) $ 15.00 per year
Individual Membership $ 20.00 per year
Family Membership $ 25.00 per year
Commercial Membership $ 50.00 per year
Dues are renewed yearly on the anniversary of your join date.
Notification will be sent by mail a few months before your membership is due to expire.

Check One:
  Pet Owner Breeder Both

I have pet birds: (Please specify species kept.)

  I breed birds: (Please specify species bred.)

How did you hear about NIPS?
I am a previous NIPS member.  
From a Friend, Relative or Co-Worker (Please specify)
At a Veterinarian's Office (Please specify)
At a Bird Fair or Show (Select all that apply)  
From a link on another website (Please specify, if known)
From an internet search (such as Google, Yahoo, etc.)
Other (Please specify)

To continue & pay for your membership using PayPal, please click on the Submit button below. Your membership will be considered in good standing upon receipt of payment. Instructions on how to access the Society's password protected Member's Only page, will be forwarded to you in the next few days to the email address you listed above.
 
If you do not receive the password information within a week, please contact webmaster@nipsparrot.org.
 
 

Membership Questions? Contact Chris Malwitz, Chairperson, at 773-278-0347 or membership@nipsparrot.org. Form problems? Contact webmaster@nipsparrot.org.

Welcome to the NIPS flock!



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Copyright © 2003-2008 Northern Illinois Parrot Society. All rights reserved.
Revised: March 09, 2008