Pine Tree Guide Dog Users Initial Membership Form

Thank you for your interest in joining PTGDU. Please provide the information below.

Annual Dues: $20. If paid after October 1st will provide membership from date of payment through December 31st of the following year.

If you choose to send us a check, please make it payable to Pine Tree Guide Dog Users, and mail the check to P.O. Box 6157, Falmouth, ME 04105. Be sure to include your name and address as entered on this form.

Pine Tree Guide Dog Users Initial Membership Form
Name
Name
First
Last
Are you, or have you ever been, a guide dog handler?
To comply with postal regulations when we send you items via the U.S. Postal Service, we need information concerning your degree of visual impairment (we are allowed to use).
As a member of GDUI, you are entitled to receive copies of the magazine, “Paws for News You Can Use” via e-mail. Please indicate if you would like to receive this publication.
As a member of ACB, you are entitled to receive ACB's magazine the Braille Forum. If you are not currently receiving the Braille Forum, or wish to change the format in which you receive it, please check one of the following.
You can pay with PayPal, credit or debit card, or by check. Please indicate which method you will use. When you click the SIGN UP NOW button, you will be redirected to a payment page. Thank you!
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