Membership Application
Sign in to Google to save your progress. Learn more
Email *
Today's date: *
MM
/
DD
/
YYYY
Membership application type:
Clear selection
First name:  *
Last name: *
Address: *
City: *
State: *
Zip code: *
Phone number: *
How many pets do you currently have registered? *
What type(s) of animal(s) do you have registered (dog, cat, etc.)?
What type of facility or facilities are you currently visiting or plan to visit? *
Required
List the name(s) of the facility/facilities you are currently visiting and how often you visit: 
*
Pet Partners of the Red River Valley membership includes voting rights and the rights to hold an officer position.

As a member of Pet Partners of the Red River Valley (PPRRV):
I understand that I am required to attend meetings and visit facilities (or community events if I currently do not have a registered pet).

I understand that it is my responsibility to positively represent PPRRV and therapy pets.

I understand that PPRRV Leadership and other members may contact me via mail, email, phone, text, other means of communication, or on social media. I will inform PPRRV by email or mail if if choose to not be included in these communications.

Membership dues:
Annual membership dues are $10.00 and are due by May 31 of each year.  

Pay via PayPal.

Or make check payable to PPRRV and mail to: 
Pet Partners of the Red River Valley
Attn: Mary Brown
906 21st Ave S
Fargo, ND  58103
By typing my name below it is the same as my signature:
*
How will you be submitting payment?
Clear selection
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy