Pets 911; Registration

Membership Application Form

Please print this form, fill it out and send to:

Pet Owners Alliance
3395 N.W. 37 Ave.
Fort Lauderdale, FL 33309

Applicant Information

Name:	_____________________________________________
Address:	_____________________________________________
City:	_____________________________________________
State or Province:	______________________ Zip Code:__________
Number & Breed of Pets	_____________________________________________ NOTE: We will send you a registration form for complete descriptions of your pets.
Phones: Res./Bus.	_____________________________________________
Emergency or Friends	_____________________
E-Mail:	_____________________________________________
*Payment Information*

________Money Order _______Check
Amount: $_________

Alliance Registration & Membership Fees

One Time Fees:
We can apply your pet's tattoo and insert the microchip - - Total cost = $48.00
If your pet has a tattoo and all you need is the microchip - Total cost - $20.00
If your pet has a microchip and you need the tattoo only - - Total cost - $28.00

Add National Registration:
Computer listing of your pet's Identification. For the first year costs - $19.00
Any additional pets registered at the same time - For the first year costs - $9.00

After the first year the total ANNUAL cost for registering ALL pets is only - $9.00

Contributing Membership:
If you do not have pets but would like to support our Animal Rescue work and help with the cost of cruelty investigations, the Annual membership fee is - - - $25.00
Your membership does count and your help is very much appreciated.

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