Washington Area Parrot Head Club


I Wanna Be A Parrot Head!!!


Name:        ________________________________________


Address:     ________________________________________






Telephone: _______________                         _______________


Email:        ________________________________________


Birth Month/Day:         _____/_____


What location do you work: __________________________ 

(This is to help us in planning activities and meetings)


Dues are $20/year per member.  Members must be 21 years old.


Please send this information and your dues check to:

WAPHC Membership

P.O. Box 1075

Springfield VA 22151-0075

or give it to one of our officers at a meeting/social/event.


Check out our event schedule at www.waphc.com


This contribution is not deductible as a charitable contribution for Federal Income Tax Purposes