American Fancy Rat and Mouse Association
Membership Application & online Breeder’s Listing Form
This form is required along with payment.

This online application form is only to be used when using PayPal to pay for the Membership dues/Breeder’s Listing

Do not press the ENTER or RETURN key!

Fields with a * are required fields.

Name(s)*:
Address 1*:
Address 2:  
City*:   State*:   Zip*:
Country (if not U.S.A): :

Telephone #:    Include Telephone # on Breeder listing? Y    N

E-mail address*:    Include E-mail on Breeder listing?* Y    N

Rattery/Mousery Name (include prefix initials–up to 4 characters):

Web Site Address:

Annual Membership Type (Individual or Family in same household; all amounts in U.S. Dollars) (includes Breeder’s Listing fee)*:

 U.S.A. Residents ($36.35)
 Canada ($41.94)
 Overseas [U.K., Europe, Australia, etc.] ($47.14)

If Family, enter Total # (include all family member names above)

Member*:   New   Renewal

Would you like your newsletters*: Online (full color PDF)   or Mailed (B/W version)

Would you like your AFRMA Show Regulations & Standards Book:*: PDF   or Printed book

Would you like your AFRMA Directory:*: PDF   or Printed book

Would you like your AFRMA Bylaws:*: PDF   or Printed

If under 18, parent name:

What do you breed?

RATS: Pets   Breeding   Show/Fancy
RATS: American   Pure English  
Standard   Rex   Tailless   Hairless   Satin   Dumbo   Bristle Coat  
Other
Markings
Colors

MICE: Pets   Breeding   Show/Fancy
MICE: Pure English   English/American   American  
Standard   Satin   Long Hair   Long Hair Satin   Frizzie   Frizzie Satin   Hairless  
Other
Markings
Colors

Do you Ship*? Y    N Conditions:

Do you have lab testing done on your animals? Y    N
Diseases tested for and results:
(send a copy of your test results (PDF, JPG, TIF) to breedlist@afrma.org)

Additional Breeder Listing Comments:

You may include a photo with your ad. Send digital photo (JPG, GIF, PNG, or TIF only) to: breedlist@afrma.org

May we refer people to you*?    Y    N

Do you plan on participating in So. California Shows*?    Y    N

How did you hear about AFRMA?

Additional Comments (optional):

In making this application for membership to the American Fancy Rat and Mouse Association, I/we agree to, if accepted into membership by the Board of Directors, abide by and be bound by the rules set by the Association.

In lieu of a signature, the submission of this form and payment of annual dues is an agreement to the terms of membership.

Before sending this form, you should print it for your records.
After you press SEND, you should get a screen thanking you for sending your application
and a “Buy Now” button to pay via PayPal.

This form is required along with payment. Payment button on the next page.



If you do not get the “Thank You” screen, then your e-mail didn’t go through and you will need
to copy this page and paste into a regular e-mail and send it to membership@afrma.org,
then send your payment via PayPal.

Updated October 31, 2017