AMERICAN COCKATIEL SOCIETY, INC.

APPLICATION FOR AFFILIATION

Dear Friends,

Thank you for affiliating with the American Cockatiel Society. All club affiliation memberships run from January l through December 31 of each year. If your Club affiliated last year, welcome back; if not, we invite you to join. If you have any questions please feel free to contact me.

Affiliation Fees:

Within the USA -- $25.00,

Canada & Mexico, $33.00

Overseas $40.00


Your Affiliation benefits include:

l. Club listing in the ACS Magazine and the ACS Web Page (www.acstiels.com) all year.

2. One year of ACS Magazine (4) for your club library

3. Use of a program to print show tags upon request.

(check one below.)

_________Yes, we would like the ACS Magazine

_________No, we do not care for a copy

For affiliated clubs that wish to have an ACS affiliated show, a minimum purchase of one best novice plaque and one best advance plaque is required for each show. Your club may host as many shows as they like for the one time fee of $25.00 plus the purchase of a best novice and best advance plaque with each show $19.50 best novice plaque, $20.00 best advance plaque, $9 for shipping - total minimum each show $48.50). See attached patronage form to report your show information and order these plaques. Along with the purchase of these plaques you are entitled to:

l. Listing of your Club's show date, location and ACS Judge in the ACS Magazine and ACS Web Page.

2. Show results listed in the ACS Magazine.

CLUB NAME:__________________________________________________________

CONTACT PERSON:____________________________________________________

ADDRESS:_____________________________________________________________

E-MAIL ADDRESS:______________________________________________________
We do not share information with third parties.

TELEPHONE NUMBER:__________________________________________________

Mail this completed application form, along with the proper fee (made payable to American Cockatiel Society) to:

Cindy Swiler,
A.C.S. Chair for Affiliated Clubs & Patronage
767 Valleyview,
Wichita, KS  67212