Pet Partner Application and Renewal

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Pet Partner Application and Renewal
DO NOT complete this form if you are NOT a registered Pet Partner OR you have not completed a successful evaluation
If you prefer to send your form by mail, Click here to print the membership form.
Scroll Down to Complete the Online Form
Membership Benefits Include:
Notification of area visiting opportunities
Social events for you and your pet partner
Educational opportunities and networking
Connection to other members
Name*
First Last
Membership Type:*
- Renewing Member $15 Annual Dues (Annual membership is from June 1 to May 31)
- New Member NO DUES *until the next Membership Drive
Pet Partners Number:
New Member: Evaluation Date:
1) Pet Partner Name:*
Pet Partner Species/Breed:*
2) Pet Partner Name:
Pet Partner Species/Breed:
3) Pet Partner Name:
Pet Partner Species/Breed:
Preferred Phone # Cell or Home:*
Ok to Text?*
- Yes
- No
Email:*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
We value member participation, so we hope you will share your talents.
Currently, I visit these facilities:
Please indicate the local Mo-Kan activities you would like to become involved with / continue to offer:
- Events (plan or participate)
- Education
- Team Evaluations
- Promotions
- Leadership
Describe additional visiting opportunities that interest you:
Describe any other interests:
Note: Mo- Kan prefers to communicate with members via email rather than more costly USPS mail. We will not use or share your contact information for any other purpose.
PLEASE READ BEFORE SIGNING: Your signature indicates that you agree to uphold the mission and standards of Mo-Kan Pet Partners as stated in our Bylaws (found at the Mo-Kan website) and that you desire to be an organizational member. Simply use your finger or mouse to. Your signature or initials are acceptable. We know this won't look perfect, but that's ok.
Signature*

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Pet Partner Application and Renewal

Membership Benefits Include:

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