Club Membership Registration Form

Membership Application
The Central Indiana Cage-Bird Club meets the second Saturday of each month at:

Gethsemane Lutheran Church

6810 E. 10th Street

Indianapolis, IN 46219

Meetings start promptly at 11am. Please allow yourself enough time for arrival so that our meetings can begin on schedule. Birds are allowed at most meetings. Please check the program schedule for specifics.

Annual Club Dues are $20/family

(January to December)
Name

First Name Last Name
E-mail
Phone Number:

Area Code Phone Number

Address:

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Where did you hear about us?

Bird Fair Friend Google Blog Post News Article
Please make check payable to:
Central Indiana Cage-Bird Club or C.I.C.B.C.

Mail to:
C.I.C.B.C. Membership
274 N Monroe St
Mooresville, IN 46158
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