North American Cockatiel Society
Membership Application

Thank you for joining via PayPal!  Please fill out the following form, 
which will be e-mailed to the NACS Band/Membership Chairperson 
to speed your acceptance!

New Household Membership: $14.00 (includes first class mail)
New Membership in Canada or Mexico: $20.00 (includes airmail)
New Membership Overseas: $26.00 (includes airmail)
Renewed Household Membership: $14.00 (includes first class mail)
Renewed Membership in Canada or Mexico: $20.00 (includes airmail)
Renewed Membership Overseas: $26.00 (includes airmail)
Renewed CHARTER Household Membership (members 1-150): 
      $12.00 (includes first class mail in USA)
Renewed CHARTER Household Membership in Canada or Mexico (members 1-150): 
      $18.00 (includes airmail)
Renewed CHARTER Household Membership Overseas (members 1-150): 
      $24.00 (includes airmail) 

       Name(s): 

Street Address: 

          City: 

         State:  Zip Code:  Country: 

  Please include area code in Phone and FAX Numbers below

  Phone Number:      FAX Number: 

E-Mail Address: 
Your Home Page URL:
Number of cockatiels I own: I am primarily a:

Name of a special pet bird(s):

Pet's hatch MONTH(S):