MEMBERSHIP DIRECTORY FORM - from WEBSITE Please Print Clearly and Fill out Completely

MEMBERSHIP DIRECTORY FORM - from WEBSITE Please Print Clearly and Fill out Completely

APWS MEMBERSHIP DIRECTORY FORM - FROM WEBSITE Please print clearly and fill out completely. Reply ASAP – deadline April 1st ATTENTION: This form MUST be returned to be included in the next Membership Directory! Send completed form to: Lisa Tate, APWS Editor, 21718 Kesa Lane, Florence, MT 59833 PLEASE DO NOT SEND ANY MEMBERSHIP FUNDS WITH THIS FORM REQUIRED - DATE FILLED OUT ______________________________________________ Name __________________________________________________________________________________________________________________________ Aviary Name __________________________________________________________________________________________________________________ Address _______________________________________________________________________________________________________________________ City ________________________________________________________________________ State/Province _________________________________ Country ___________________________________________________________ Zip ________________________________+4___________________ Phone ___________________________________________ Fax ________________________________ Cell __________________________________ Email _________________________________________________________________________________________________________________________ Website ______________________________________________________________________________________________________________________ PLEASE CIRCLE THE NUMBER NEXT TO EACH SPECIES YOU KEEP PHEASANTS (PH) PEACOCK-PHEASANTS 7 - MOUNTAIN BAMBOO JUNGLEFOWL (JF) 41 – GERMAIN’S 8 - SEE SEE 1 - RED TRUE PHEASANTS 42 – GREY 9 – STONE 2 – SONNERAT/GREY 1 – RING-NECKED 43 – PALAWAN 10 - PAINTED 3 - CEYLON 2 – BLACKNECK 44 – BRONZED TAIL 11 - CLOSE BARRED 4 – GREEN 3 – BIANCHI 45 – MALAY 12 - ROUL ROUL 4 – FORMOSAN 46 – MOUNTAIN 13 - TIBETAN HILL WATERFOWL (WD) 5 - VERSICOLOR 47 - BORNEAN 14 - SUMATRAN HILL 6 – STRAUCH 15 - MADAGASCAR DABBLING DUCKS TRAGOPANS 16 - FERRUGINOUS WOOD 7 - ZARUDNYI 48 – SATYR 1 - CAPE TEAL 8 - ZERAFSHAN 17 - PHILBY’S ROCK 2 - HOTTENTOT TEAL 49 – TEMMINCK’S 18 – OTHER PARTRIDGE SPECIES 9- MONGOLIAN 50 – CABOTS 3 - SILVER TEAL 10- MANCHURIAN 4 - PUNA TEAL 51 - WESTERN QUAIL (Q) 11– OTHER TRUE PHEASANT SP. 52 - BLYTH’S 5 - RED-BILLED PINTAIL 12– RING-NECKED MUTATIONS 1 - NORTHERN BOBWHITE 6 - BAHAMA PINTAIL OTHER PHEASANTS 2 - N. BOBWHITE MUTATIONS 7 - SOUTH GEORGIA PINTAIL RUFFED PHEASANTS 53 - CRESTED ARGUS 3 - MASKED BOBWHITE 8 - YELLOW-BILLED PINTAIL 13 – GOLDEN 54 – MAYLAY ARGUS 4 - VALLEY 9 - NORTHERN PINTAIL 14 – GOLDEN MUTATIONS 55 – IMPEYAN 5 - GAMBEL’S 10 - CHILEAN TEAL 15 – AMHERST 56 – KOKLASS 6 - CHESTNUT BELLIED 11 - SHARP-WINGED TEAL 57 – CHEER 7 - BLUE SCALED 12 - EUROPEAN COMMON TEAL GALLO PHEASANTS 58 – BLOOD 8 - BENSON 13 - AMER.GREEN-WINGED TEAL 16 – NEPAL KALIJ 59 – OTHER PHEASANT SPECIES 9 - MEARNS 14 - BAIKAL TEAL 17 – WHITE CRESTED KALIJ 10 - MOUNTAIN 15 - GREY TEAL 18 – CRAWFORDS KALIJ PEAFOWL (PF) 11 - HARLEQUIN 16 – CHESTNUT TEAL 19 – LINEATED KALIJ 1 - BLUE 12 – JAPANESE/COTURNIX 17 - MADAGASCAR TEAL 20 – HORSFIELD’S KALIJ 2 - GREEN 13 - BUTTON 18 - WILD MALLARD 21 – SILVER (NOMINATE) 3 - PEAFOWL MUTATIONS 14 - JUNGLE BUSH 19 - FLORIDA MOTTLED 22 - OTHER SILVER RACE 15 - ROCK BUSH 20 - LOUISIANNA MOTTLED 23 – SWINHOE FRANCOLIN (F) 16 - RAIN 21 - AMERICAN BLACK DUCK 24 – EDWARD’S 1 - ERKELS 17 – OTHER QUAIL SPECIES 22 - HAWAIIAN DUCK 25 – SIAMESE FIREBACK 2 - YELLOW THROAT 23 - LAYSAN DUCK 26 – MALAYAN FIREBACK 3 - HEUGLINS GROUSE (G) 24 - INDIAN SPOT-BILLED 27 – MAYLAY CRESTLESS 4 - HUMBOLTS 1 - RUFFED 25 - CHINESE SPOT-BILLED 28 – BORNEAN 5 - HYDERBADIE 2 - SHARP-TAILED 26 - PACIFIC BLACK DUCK 29 – BORNEAN CRESTLESS 6 - CLOSE-BARRED 3 - BLUE 27 - PHILIPPINE DUCK 30 - BULWER’S PHEASANT 7 – BLACK 4 - WILLOW PTARMIGAN 28 - MELLER’S DUCK EARED PHEASANTS 8 – OTHER FRANCOLIN SPECIES 5 - ROCK PTARMIGAN 29 - AFRICAN YELLOW-BILLED 31 – BLUE 6 - PRAIRIE CHICKEN 30 - AFRICAN BLACK DUCK 32 – BROWN PARTRIDGE (PT) 7 - SPRUCE 31 - FALCATED DUCK 33 – WHITE 1 - CHUKAR 8 - SAGE 32 - GADWALL 2 - CHUKAR MUTATIONS 9 - CAPERCAILLIE 33 - EURASIAN WIGEON LONG TAILED PHEASANTS 3 - RED-LEGGED 10 - BLACK 34 - AMERICAN WIGEON 34 – REEVES 4 - BARBARY 11 - RED 35 - CHILOE WIGEON 35 – ELLIOTS 5 - HUNGARIAN 12 - HAZEL 36 - BLUE-WINGED TEAL 36 – SCINTILLATING COPPER 6 - CHINESE BAMBOO 13 - SNOW COCK 37 - CINNAMON TEAL 37 – SOEMMERING COPPER 14 – OTHER GROUSE SPECIES 38 – IJIMA COPPER 39 – HUME’S 40 – MIKADO PLEASE CIRCLE THE NUMBER NEXT TO EACH SPECIES YOU KEEP DABBLING DUCKS, CONTINUED SEA DUCKS SHELDUCKS SWANS (WS) 120 - RUDDY 38 - GARGANEY 77 – EUROPEAN COMMON EIDER 1 - MUTE 121 - CAPE 39 - RED SHOVELER 78 - PACIFIC COMMON EIDER 2 - BLACK 122- AUSTRALIAN 40 - AUSTRALIAN SHOVELER 79 - FAROE COMMON EIDER 3 - BLACK-NECKED 123 - N.Z./PARADISE 41 - NEW ZEALAND SHOVELER 80 - AMERICAN COMMON EIDER 4 - COSCOROBA 124 - RADJAH 42 - NORTHERN SHOVELER 81 - OTHER COMM. EIDER RACE 5 – TUNDRA/WHISTLING 125 – COMMON/EUROPEAN 43 - RINGED TEAL 82 - KING EIDER 6 - BEWICK’S 44 - BRAZILIAN TEAL 83 - SPECTACLED EIDER 7 - TRUMPETER 45 - BRONZE-WINGED DUCK 84 - STELLER’S EIDER GEESE (WG) 8 - WHOOPER 46- CRESTED DUCK 85 - BLACK SCOTER 1 - SWAN GOOSE 86 - COMMON SCOTER 2 - PINK-FOOTED MISCELLANEOUS (MS) 3 - PACIFIC WHITE-FRONTED 87 - SURF SCOTER 1 - WILD DOVES/PIGEONS PERCHING DUCKS 4 - TULE GOOSE 88 - WHITE-WINGED SCOTER 2 - FRUIT DOVES/PIGEONS 47 - MANED/AUSTRALIAN WOOD 5 - LESSER WHITE-FRONTED 89 - VELVET SCOTER 3 - PASSERINES 48 - MANDARIN 6 - WESTERN GRAYLAG 90 - HARLEQUIN DUCK 4 - PARROTS/HOOK-BILLS 49 - MANDARIN MUTATIONS 7 - EASTERN GRAYLAG 91 - LONG-TAILED/OLDSQUAW 5 - TOUCANS/ARACARIS 50 - NORTH AMER. WOOD DUCK 8 - BAR-HEADED 92 - BARROW’S GOLDENEYE 6 - TOURACOS 51 - WOOD DUCK MUTATIONS 9 - EMPEROR 93 - COMMON GOLDENEYE 7 - CHACHALACAS 52 - AFRICAN PYGMY 10 - LESSER SNOW (WHITE) 94 - BUFFLEHEAD 8 - CURASSOWS 53 - GREEN PYGMY 11 - LESSER SNOW (BLUE) 95 - SMEW 9 – GUANS 54 - INDIAN PYGMY 12 - GREATER SNOW 96 - HOODED MERGANSER 10 – WILD TURKEY 55 – OLD WORLD COMB DUCK 13 - ROSS’ 97 - RED-BREASTED MERGANSER 11 – OCELLATED TURKEY 56 – NEW WORLD COMB DUCK 14 - ATLANTIC CANADA 98 - AMERICAN/COMM. MERG. 12 – WILD GUINEAFOWL 57 - HARTLAUB’S DUCK 15 - GIANT CANADA 99 - GOOSANDER 13 - TINAMOU 58 - WHITE-WINGED WOOD DUCK 16 - DUSKY CANADA 59 - WILD MUSCOVY 100 - SCALY-SIDED MERGANSER 14 - OSTRICH 17 - OTHER CANADA RACE 15 - RHEA 60 - WHITE SPUR-WINGED GOOSE 18 - ALEUTIAN CACKLING 61 - BLACK SPUR-WINGED GOOSE 16 - EMU WHISTLING-DUCKS 19 - RICHARDSON’S CACKLING 17 - CASSOWARY 101 - SPOTTED 20 - CACKLING (NOMINATE) POCHARDS 18 - CRANES 102 - EYTON’S/PLUMED 21 - OTHER CACKLING RACE 19 - SCREAMERS 62 - MARBLED TEAL 103 - WANDERING 22 - HAWAIIAN/NENE 63 - RED-CRESTED POCHARD 20 - FLAMINGOS 104 - FULVOUS 23 - BARNACLE 21 - COOTS 64 - ROSY-BILLED POCHARD 105 – CUBAN/BLACK-BILLED 24 - RUSSIAN BRANT 65 – SOUTHERN POCHARD 22 - RAILS 106 - JAVAN/LESSER 25 - ATLANTIC BRANT 23 - SHOREBIRDS 66 - CANVASBACK 107 - WHITE-FACED 26 - PACIFIC BRANT 67 – EURO/COMMON POCHARD 24 - BIRDS OF PREY 108 – BLACK-BELLIED 27 - GRAY-BELLIED BRANT 25 - OTHER WILD BIRDS 68 - REDHEAD 109 - WHITE-BACKED 28 - RED-BREASTED 69 – FERRUGINOUS WHITE-EYE 26 - WILD MAMMALS 70 - BAER’S POCHARD STIFF-TAILED DUCKS SHELDGEESE 71 - AUSTRALIAN WHITE-EYE 110 - WHITE-HEADED 29 - EGYPTIAN DOMESTIC BREEDS (DB) 72 – NEW ZEALAND SCAUP 111 – NORTH AMER. RUDDY 30 - ORINOCO 1 - DOMESTIC DOVES/PIGEONS 73 - RING-NECKED DUCK 112 - ARGENTINE/LAKE 31 - BLUE-WINGED 2 - DOMESTIC CHICKENS 74 – TUFTED DUCK 113 - MACCOA 32 - ANDEAN 3 - DOMESTIC TURKEYS 75 - LESSER SCAUP 114 - BLACK-HEADED 33 - ASHY-HEADED 4 - DOMESTIC WATERFOWL 76 - GREATER SCAUP 34 - RUDDY-HEADED 5 - DOMESTIC GUINEAFOWL TAXONOMIC ODDITIES 35 - LESSER MAGELLAN 6 - OTHER DOMESTIC POULTRY 115 - PINK-EARED DUCK 36 - GREATER MAGELLAN 7 - DOMESTIC LIVESTOCK 116- FRECKLED DUCK 37 - CEREOPSIS/CAPE BARREN 117 - MAGPIE GOOSE 118 - FLYING STEAMER DUCK 119 - MAGELLANIC STEAMER ATTENTION: This form MUST be returned to be included in the Membership Directory! Please reply ASAP. Return deadline: April 1st Want to advertise in the Directory? ¼ page: $20.00 – ½ page $40.00 – Full page $80.00 Mail your ad and payment with this form to E.T.Trader, 7153 Piney Island Road, Chincoteague Island, VA 23336.

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