AFRMA Breeder’s Listing Form

American Fancy Rat and Mouse Association

CURRENT MEMBERS BREEDER’S LIST FORM

(Membership in AFRMA is required to be listed.)

New Members please use the combined Membership/Breeder’s form

Payment is required with this application.

This on-line application form is only to be used when using PayPal to pay for the Breeder’s Listing

Do not press the ENTER or RETURN key!

Fields with a * are required fields.

Name(s)*:
City*: State*:

Telephone #: Include Telephone # on listing? Y N

E-mail address*: Include E-mail on listing?* Y N

Rattery/Mousery Name (include prefix initials–up to 4 characters):
Web Site Address:

Annual Breeder’s Listing fee (in U.S. Dollars)*:

U.S.A. ($10.87)
Canada/Overseas ($11.04)

Listing*: New Renewal

I Breed:
RATS: Standard Rex Tailless Hairless Satin Dumbo Bristle Coat
Other
Markings
Colors

MICE: Pure English English/American American
Standard Satin Long Hair Long Hair Satin Frizzie Frizzie Satin Hairless
Other
Markings
Colors

Do you Ship*? Y N Conditions:

Do you have lab testing done on your animals*? Y N
Diseases tested for and results:
(send a copy of your test results [PDF, JPG, TIF] to breedlist@afrma.org)

Additional Comments:

You may include a photo with your ad. Send digital photo (JPG, GIF, PNG, or TIF only) to: breedlist@afrma.org

Before sending this form, you should print it for your records.
After you press SEND, you should get a screen thanking you for sending your application
and a “Pay Now” button to pay via PayPal.

This form is required along with payment. Payment button on the next page.

If you do not get the “Thank You” screen, then your e-mail didn’t go through and you will need
to print this form to a PDF and save file (OR in Firefox you can right mouse click, "Take Screenshot," save full page, download, save the file),
then attach your PDF file (or screenshot file) to an e-mail and send to breedlist@afrma.org,
then send your payment via PayPal.

Updated November 17, 2022