American Fancy Rat and Mouse Association
(Membership in AFRMA is required to be listed.)

New Members please use the combined Membership/Breeder’s form

Payment is required with this application.

This on-line application form is only to be used when using PayPal to pay for the Breeder’s Listing

Do not press the ENTER or RETURN key!

Fields with a * are required fields.

City*:   State*:

Telephone #:    Include Telephone # on listing? Y    N

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

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

Annual Breeder’s Listing fee (in U.S. Dollars)*:

 U.S.A. ($10.87)
 Canada/Overseas ($11.04)

Listing*:   New   Renewal

I Breed:
RATS: Standard   Rex   Tailless   Hairless   Satin   Dumbo   Bristle Coat  

MICE: Pure English   English/American   American  
Standard   Satin   Long Hair   Long Hair Satin   Frizzie   Frizzie Satin   Hairless  

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

Additional Comments:

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

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 “Pay 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 print this form to a PDF and save file (OR in Firefox you can right mouse click, "Take Screenshot," save full page, download, save the file),
then attach your PDF file (or screenshot file) to an e-mail and send to,
then send your payment via PayPal.

Updated November 17, 2022