| Name: | _________________________________________________________________ | # of dogs owned: | __________________ | ||
| Address: | _________________________________________________________________ | ||||
| City: | ___________________________________________ | State: | ____________ | Zip: | ___________ |
| Home Phone: | __________________________ | Cell Phone: | __________________________ | ||
| Email: | _________________________________________________________________ | ||||
| Signature: | _________________________________________________________________ | ||||
Membership fee is $20.00 per single membership or $30.00 per family membership.
Please make check payable to ’NHMA’
Please mail to NHMA c/o Bob Heckman, 53 Wadleigh Point Rd., Kingston, NH 03848