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 NameLast Name
E-mail
Phone Number:

Area CodePhone Number
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Where did you hear about us?

Bird FairFriendGoogleBlog PostNews 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
5943 Copeland Mills Drive
Indianapolis, IN 46221
Should be Empty: