If you would like to join, print application form and mail to: Julie Peterson, IaPBA President
3434 Little Wall Lake Rd.
Jewel, Iowa 50130
You can contact Julie at: 515-836-8114 or email at: eandc@netins.net
MEMBERSHIP APPLICATION ( PLEASE PRINT CLEARLY ) MEMBERSHIP FEE $50.00
NAME _______________________________________ DATE _______________NEW ______RENEWAL______
BUSINESS NAME (IF ANY) _____________________________________________________________
ADDRESS____________________________________________________________________________
CITY ___________________________________________ STATE________ZIP___________________
HOME PHONE # ________________________________ FAX___________________________________
CELL PHONE # ___________________________ E-MAIL ADDRESS_________________________________
WEBSITE (IF APPLICABLE)________________________________________________________________
USDA #___________________________ STATE LICENSE#_________________________________
FAX, CELL PHONE, E-MAIL ARE OPTIONAL IF YOU WANT THEM LISTED IN NEXT DIRECTORY.
If you want in the Membership Directory write yes in blank ___________________
If you want to be listed on the website of IaPBA write yes in the blank_____________
(CIRCLE BREEDS)
AKITA DOBERMAN PINSCHER MASTIFF SCHNAUZER (MIN) ALASKAN MALAMUTE ENGLISH BULL DOG MIN. PINSCHER SCOTTISH TERRIER
AMERICAN BULLDOG ENGLISH SETTER NEWFOUNDLAND SHAR PEI
AMERICAN ESKIMO ENG. SPRINGER SPANIEL NORWEGIAN ELKHOUND SHETLAND SHEEPDOG
AUSTRALIAN TERRIER FOX TERRIER (SMOOTH) OLD ENGLISH SHEEPDOG SHIBA INU
BASSET HOUND FOX TERRIER (TOY) ORI PEI SHIH POO
BEAGLE FRENCH BULL DOG ORIG. MOUNTAIN CUR SIBERIAN HUSKY
BERNESE MOUNTAIN DOG GERMAN SHEPHERD PAPILLON SILKY TERRIER
BICHON FRISE GERMAN SHORTHAIR PTR. PEKE-A-POO SNOODLE
BICHON POO GOLDEN RETRIEVER PEKINGESE SOFT-COATED WHEATEN
BOSTON TERRIER GREAT DANE PEMBROKE WELSH CORGI TEDDY BEAR
BOXER GREAT PYRANESE POMERANIAN WEIMARANER
BRITTANY SPANIEL IRISH WOLFHOUND POOS WELSH TERRIER
CAIRN TERRIER ITALIAN GREYHOUND POODLE (TOY WEST HIGHLAND WHITE TERRIER
CHIHUAHUA JACK RUSSEL TERRIER POODLE (MIN.) YORKIE POO
CHINESE CRESTED JAPANESE CHIN POODLE (STAND.) YORKSHIRE TERRIER
CHOW CHOW KEESHOND PUG
COCK-A-POO KEMMER CUR PUGNESE
COCKER SPANIEL LABRADOR RETREIVER RAT TERRIER
COLLIE LHASA APSO ROTTWEILER
DACHSHUND (MIN) LHASA POO SAINT BERNARD
DACHSHUND (STAND) MALTESE SAMOYED
DALMATIAN MALTIPOO SCHIPPERKE