Please make checks payable to
Canine Political Action Corps.

Mail your check and
this completed form to:

      CPAC
      1443 Farmside Drive
      Foristell, MO 63348

 
Business Name _________________________
 
Groomer [  ]   Trainer [  ]   Both [  ]   N/A [  ]
 
Name _________________________
 
Address _________________________
  _________________________
City _________________________
State _________________________
ZIP Code _________________________
 
Telephone _________________________
 
Email _________________________
  [  ] Receive email newsletter
[  ]
 Individual Membership
$50
A membership option for individuals that renew annually.
[  ]
 Individual Lifetime Membership
$500
A one-time lifetime membership option for individuals that never requires renewal. In addition, your name will be listed on the CPAC website as a lifetime member.
[  ]
 Business Membership
$100
A membership option for your business that renews annually. Your business name and a link to your business website will be listed on the CPAC website.
  Sponsorships
All sponsors will be listed on the CPAC website with their company logo, contact info, and company website.
[  ]
 Bronze Sponsor
$250 or more
[  ]
 Silver Sponsor
$500 or more
[  ]
 Gold Sponsor
$1000 or more
[  ]
 Platinum Sponsor
$2000 or more
[  ]
 Premier Sponsor
$3000 or more
[  ]
Additional Donation: $ 
Additional Donation: $ __________
Membership donations of $100 or less and lifetime memberships are not deductible as charitable contributions.
 
   
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