American Pet Products Manufacturers Association, Inc.
255 Glenville Road
Greenwich, CT 06831
Tel: (800) 452 1225   Fax: (203) 532 0551

APPLICATION FOR DOMESTIC LIVESTOCK MEMBERSHIP

APPMA accepts into membership livestock suppliers which breed/sell domesticated companion animals in the following categories: dog, cat, fish, bird, small animal, reptile and equine. Livestock must be intended for sale as companion animals at the retail level. Membership applications are reviewed and approved by the APPMA Board based on these qualifications.

The undersigned hereby makes application for Domestic Livestock Membership in American Pet Products Manufacturers Association, Inc. (APPMA) and, if accepted for membership by the Board of Directors, agrees to abide by all the Rules, Regulations and By-Laws of said Association.

Directions: Please complete this form in its entirety, by typing your response or, where appropriate, indicating "Not Applicable." Incomplete information or documentation will delay processing and consideration of this application. The information contained in this application will remain confidential except to the extent necessary for consideration of membership and/or provision of member services.

Company and Key Contact Information
Firm Name:
Contact Name:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:	(Please include area/city and country code)
Fax:	(Please include area/city and country code)
E-mail Address:
Web Site URL:
Business Profile:
2. Name the type of business the applicant is organized as (e.g., corporation, partnership, sole proprietorship, etc.):
3. Please list the type of supplier you are (i.e. bird, cat, dog, equine, fish, reptile, small animal):: Please provide a copy of your pet brochure or advertisement indicating that you are a supplier of domesticated companion animals.
4. Are your domesticated companion animals being sold to retail pet shops? Yes   No Please submit one (1) invoice showing the sale of your animals to a retail pet shop or distributor along with a matching bill of lading showing the shipment of the companion animals from your facility.
5. What percentage of your pet product income is derived from: a. Distribution of companion animals: % b. Breeding of companion animals: % c. Other: % If Other, Please Specify:
6. Do you have a breeding/kennel/cattery facility or distribution center? Yes   No Please enter the address of your facility:
8. Number of Employees. Indicate the number of full-time employees in your company (employees in pet products division only). Company information will remain strictly confidential.: Less than 10 11 - 25 26 - 50 51 - 100 101 - 250 251 - 500 More than 500
8. Pet Product Sales Indicate which category of total annual worldwide sales of domesticated companion animals is applicable and enclose the stated dues amount with this application. Company sales information will remain strictly confidential. Under $0.5 MM ($500) Between $0.5 MM and $2 MM ($750) Between $2 MM and $5 MM ($1,500) Between $5 MM and $10 MM ($3,000) Between $10 MM and $15 MM ($4,800) Between $15 MM and $25 MM ($5,500) Between $25 MM and $50 MM ($6,500) Between $50 MM and $100 MM ($7,500) $100 MM and over ($10,000)
9. I certify that the above information is correct as stated including the fact that my company's annual sales of domesticated companion animals for the last fiscal year were in the category indicated above. I understand that should this information be incorrect, this application will be rejected. I further understand that if the application is accepted and later discovered to be incorrect, my company's membership will be terminated.
10. Membership applications withdrawn before presentation to APPMA's Board of Directors will be assessed a $75.00 processing fee. No credit or refund will be issued for the withdrawal of a membership application after the Board's approval, regardless of reason.
Signature:   Date:   As an Officer of:

American Pet Products Manufacturers Association, Inc.
Domestic Livestock Membership Application Checklist

Please be sure to include the following enclosures:

• Application signed by an officer of the applicant's company. (Items left blank or unclear constitute an incomplete application which cannot be considered.)
• Copy of the proper documentation (as indicated in item #3 of this application).
• Copy of one (1) invoice indicating sales of applicant's domesticated companion animals to a retail pet shop or distributor along with a matching bill of lading or shipping document (i.e. FedEx, UPS, Airborne or DHL, etc.) showing the shipment of the companion animals from your U.S. facility (as indicated in item #4 of this application).
• Initiation fee ($1,000 USD) plus first year's dues based on the annual worldwide sales of your domesticated companion animals (as indicated in item #8 of this application). Payment may be made by check, money order, or credit card Ð MasterCard, Visa or American Express.

Please mail the completed application, one (1) invoice verifying the sale of your domesticated companion animals and the initiation fee and dues payment to:

APPMA Membership Dept.
255 Glenville Road
Greenwich, CT 06831