Pennsylvania Avicultural Society MEMBERSHIP APPLICATION

CIRCLE ONE 1 YEAR 2 YEARS New Adult Membership $20.00 $35.00 Renewal $15.00 $30.00 Family Membership $25.00 $50.00 New Junior Membership $10.00 N/A Junior Renewal $7.50 N/A Donation (help with mailing, etc.)

Membership in the PAAVSOC will be from January 2 to December 31 of each year. Membership must be received NO LATER THAN MARCH 15 to be included in the ANNUAL MEMBERSHIP DIRECTORY.

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Aviary Name

Address

Cirty State Zip

Phone

Email

On the reverse oft his form, please circle all that you raise.

Make checks payable to PAAVSOC. Remit this completed form (front and back) to:

Barb Teats 312 White Pine Drive Stroudsburg, PA 18360 PHEASANTS (PH) 11 SOUTH GEORGIA TEAL POCHARDS 12 BARHEAO 13 CLOSE BARRED 1 RINGNECK 12 CHILEAN PINTAIL 80 RED CRESTED 13 EMPEROR 14 ROULROUL 2 WHITE 13 NORTHERN PINTAIL 81 ROSYBILL 14 LESSER SNOW 15 TI8EMANHILL 3 BLACKNECK 14 CHILEAN JEAL 82 AFRICAN 15 GREATER SNOW 16 SUMATRANIIILL 4BIANCHI 15 SHARPWING TEAL 83 CANVASBACK 16 ROSS 17 MADAGASCAR 5 FORMOSAN 16 EUROPEAN GREENW1NG TEAL 84 EUROPEAN 17 AILANTIC CANADA 18 FERRUGINOUS WOOD 6 OTHER COLOR 17 AMERICAN GREENWING TEAL 85 REDHEAD 18 MOFFIFS CANADA 19 OTHER SPECIES 18 BAIKAL TEAL 86 COMMON WHITEYE 19 GIANT CANADA RUFFED 19 AUSTRALIAN GRAY TEAL 87 BEARS 20 LESSER CANADA QUAIL (Q) 7 GOLDEN 20 CHESTNUT BREASTED TEAL 88 AUSTRALIAN WHITEYE 21 TAVERNERS CANADA 1 BOBWHITE 8DARK THROAT 21 NEW ZEALAND BROWN TEAL 89 NEW ZEALAND SCAUP 22 DUSKY CANADA 2 BLOND 9GHIGI YELLOW 22 MALLARD 90 RING-NECK 23 VANCOUVER CANADA 3 ORANGE 10 LADY AMHEARST 23 FLORIDA 91 TUFTED 24 ALEUTIAN CANADA 4 TENNESSEE RED 24 MEXICAN DUCK 92 LESSER SCAUP 25 RICHARDSON 5 WHITE GALLO 25 N A BLACK DUCK 93 CHEATER SCAUP 26 CACKLING 6 MASKED 11 NEPAL KALIJ 26 HAWAIIAN DUCK 27 HAWAIIAN 7 SILVER BOB 12 WHITE CREST 27 LAYSANTEAL 28 BARNACLE 8 BARRED BOB 13 CRAWFORDS 28 INDIAN SPOTBILL 29 RUSSIAN BRENT 9 VALLEY 14 LINEATED 29CHINESE SPOTBILL 30 ATLANTIC BRENT 10 GAMBEL 15 HORSFIELD 30 NEW ZEALAND GRAY DUCK 31 PACIFIC BRENT 11 CHESTNUT BELLIED 16 SILVER 31 PELEW ISLAND GRAY DUCK 32 RED BREASTED 12 BLUE SCALED 17 SWINHOE 32 AUSTRALIAN BLACK DUCK 13 BENSON 18 EDWARDS 33 PHILLIPINE DUCK SHELLGEESE 14 COLUMBIAN CRESTED 19 IMPERIAL 34 MELLERSDUCK 33 EGYPTIAN 15 MEARNES 20 SIAMESE FIREBACK 35 AFRICAN YELLOWBILL 34 ORINOCO 16 MOUNTAIN 21 MALAYAN FIREBACK 36 AFRICAN BLACK DUCK 35 ABYSSINIAN 17 HARLEQUIN 22 MAYLAY CRESTLESS 37 FALCATED DUCK 36 ANDEAN 18 JAPANESE 23 B0RNEAN 38 GADWALL 37 ASHY HEADED 19 BUTTON 24 BORNEAN CRESTLESS 39 EUROPEAN WIGEON PERCHING 38 RUDDY HEADED 20 JUNGLE BUSH 25 BULWER'S 40 AMERICAN WIGEON 94 LESSER BRAZILIAN TEAL 39 LESSER MAGELLAN 21 ROCK BUSH 41 BLACK EAST INDIAN 95 GREATER BRAZILIAN TEAL 40 GREATER MAGELLAN 22 RAIN EARED 42 BLUE WING TEAL 96 MANED 41 KELP GOOSE 23 BANDED 26 BLUE 43 ARGENTINE CINNAMON TEAL 97 MANDARIN 42 CEREOPSIS 24 TREE 27 BROWN 44 NORTHERN CINNAMON TEAL 98 25 WOOD 28 WHITE 45 GARGANEY 99 AFRICAN PYGMY GOOSE (WS) 26 COTURNIX 46 ARGENTINE RED SHOVELER 100 AUSTRALIAN GREEN PYGMY 1 MUTE 27 OTHER LONG-TAILED 47 CAPE SHOVELER 101 INDIAN PYGMY 2 POLISH 29 REEVES 48 AUSTRALIAN SHOVELER 102 COMB (OLD WORLD) 3 BLACK GROUSE (G) 30 ELLIOTS 49 NEW ZEALAND SHOVELER 103 COMB (NEW WORLD) 4 BLACK-NECK 1 RUFFED 31 SCINTILLATING COPPER 50 COMMON SHOVELER 104 HARTLAUB 5 COSCOROBA 2 SHARPTAIL 32 SOEMMERING COOPER 51 RINGED TEAL 105 WHITE WINGED WOOD DUCK 6 WHISTLER 3 BLUE 33 IJIMA COPPER 52 PINK EARED DUCK 106 WILD MUSCOVEY 7 BEWICK'S 4 PTARMIGAN 34 HUMES 107 SPUR-WINGED GOOSE 8 TRUMPETER 5 PRAIRIE CHICKEN 35 MIKADO TREE-DUCKS 108 BLACK SPUR-WINGED 9 WHOOPER 6 SPRUCE 53 MAGPIE GOOSE 109 AMERICAN BLACK SCOTER 7 SAGE PEACOCK PHEASANTS 54 SPOTTED WHISTLING 110 SURF SCOTER PEAFOWL (PF) 8 CAPERCAILLIE 36 GERMAINS 55 EYTONS WHISTLING 111 WHITE WING SCOTER 1 BLUE 9 BLACK 37 GREY 56 WANDERING WHISTLING 112 HARLEQUIN 2 BLACK SHOULDER 10 RED 38 PALAWAN 57 FULVOUS WHISTLING 113 OLD SQUAW 3 WHITE 11 HAZEL 39 BRONZEDIAIL 58 CUBAN WHISTLING 114 BARROWS GOLDENEYE 4 SPAULOING 12 SNOW COCK 40 MALAY 59 JAVAN WHISTLING 115 EUROPEAN GOLDENEYE 5 PIED 60 WHITE FACED 116 AMERICAN GOLDENEYE 6GREEN JUNGLE FOWL (JF) TRAGOPANS 61 RED BILLED 117 B U FFLEHEAD 7 CAMEO 1 RED 41 SATYR 118 SMEW 8 OTHER COLOR 2SONNERATS 42 TEMMINCKS SHELDUCK 119 HOODED MERGANSER 3 CEYLOHS 43 CABOIS 62 RUDDY 120 RED BREASTED FRANCOLIN (F) 4 GREEN 44 BLYTH-S 63 CAPE 121 AMERICAN 1 ERKELS MISCELLANEOUS (MS) 64 AUSTRALIAN 2 YELLOW THROAT 1 DOVES OTHERS 65 NEW ZEALAND STIFFTAILS 3 HEUGLINS 2 WILD TURKEYS 45 MALAY ARGUS 66 RADJAH 122 WHITE-HEADED 4 HUMBOLTS 3GUINEFOWL 46 IMPEYAN 67 COMMON 123 NORTH AMERICAN RUODY 5 HYOERBAOIE 4 CRANES 47 KOKLASS 124 ARGENTINE RUDDY 6 CLOSE-BARRED 5 CHACHALACA 48 CHEER CRESTED & STEAMERS 125 AFRICAN MACOOA 7 BLACK 6 SPUR-FOWL 49 BLOOD 68 FLYING 126 BLACK HEADED 7 CURRASOWS 69 MAGELLANIC PARTRIDGE (PT) 8 PARROT TYPE WATERFOWL DUCKS 70 FALKLAND ISLAND WATERFOWL GEESE (WD) 1CHUKER 9 TINAMOU (WD) 71 PATAGONIAN CRESTED 1 SWAN GOOSE 2 ALBINO 10 SCREAMERS 1MARBLED TEAL 72 ANDEAN CRESTED 2 WESTERN BEAN 3 WHITE 11 OSTRICH 2 BRONZEWING DUCK 3 RUSSIAN BEAN 4 FRENCH RED LEG 12 RHEA 3 CAPE TEAL EIDERS 4PINK FOOTED 5 SPANISH RED LEG 13 EMU 4 HOTTENTOT TEAL 73 EUROPEAN 5 EUROPEAN WHITE FRONT 6 BAR8ARY 14 FLAMINGOES 5 NORTHERN 74 PACIFIC 6 PACIFIC WHITE FRONT 7 HUNGARIAN 15 COOTS 6 SOUTHERN SILVER TEAL 75 NORTHERN 7GREENLAND WHITE FRONT 8CHINESE BAMBOO 16 DEER 7 PUNA TEAL 76 AMERICAN 8 TULE GOOSE 9 SEE SEE 17 LLAMAS 8 RED BILLED PINTAIL 77 KING 9LESSER WHITE FRONT 10 FORMOSAN BAMBOO 18 DONKEYS 9 LESSER BAHAMA PINTAIL 78 SPECTACLED 10 WESTERN GRAYLEG 11 STO N E 19 BANTAM CHICKENS 10 GREATER BAHAMA PINTAIL 79 STELLARS 11 EASTERN GRAYLEG 12 PAINTED 20 OTHER