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Membership Form

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PRINT OUT THIS FORM AND MAIL WITH YOUR PAYMENT  TO:

CPPGA, PO BOX 1211, ARVADA, COLORADO, 80001-1211

MAKE CHECK PAYABLE TO CPPGA OR:

CC#:_____________________________    VISA/MC     EXPIRATION DATE: _______
Initial dues are $44 for the calendar year, with the renewal rate at just $34.

APPLICATION FOR MEMBERSHIP

Please complete all the blanks below so that we can accurately process your membership request.  Mail your completed application with payment to the Colorado Professional Pet
Groomers’ Association (CPPGA), call our voice mail @ (303) 629-3022 or e-mail: secretary@cppga.org.  Please note:  Membership in CPPGA is available on an individual
basis only – no corporate requests, please. 

Name:_____________________________ Work Phone:________________ Home Phone:_________________

Mailing address: (Home___ or Work___) ________________________________________________________

City, State, Zip code:_____________________________________ E-Mail:_____________________________

Are you currently employed as a pet groomer? ______or own your own grooming business? _______

If you are a business owner in Colorado do you have a current PACFA license?  Yes____  No_____

Complete Name and Address of your business or your current/most recent employer:

Name:___________________________________________________________________________________

Address:__________________________________________________________________________________

            Please state your education related to pet grooming (schools, seminars, apprenticeships, etc.):

_________________________________________________________________________________________

_________________________________________________________________________________________

            Are you certified, or working on your certification?

Certification organization:  NDGAA___   IPG___   ISCC___

What legs or classes have you completed? _____________________________________________________

_________________________________________________________________________________________

            Please list any other pet-related experience:  _______________________________________________

_________________________________________________________________________________________

            Have you ever been charged or convicted of animal abuse?  Yes ____ No ____  If yes please explain:

_________________________________________________________________________________________

                                                                             (over)   

Please state your reason for joining the Colorado Professional Pet Groomers’ Association:

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________             _______________________________________________        _______________

Birthday (month/day only)                                 Signature                                                                    Date

Please PRINT your name as you would like it to appear on your Membership Certificate:

_______________________________________________________________________

ADDITIONAL MEMBERSHIP INFORMATION

In addition to the many intangible benefits associated with membership, you also receive:

8 ½” x 11” Membership Certificate

printed with your name, to display at your facility

C.P.P.G.A. Membership Card

Code of Ethics/Definition of a Groomer

C.P.P.G.A. By-Laws

Copy of Colorado PACFA regulations

“Incident” Form (may be reprinted)

F.Y.I. Notice

CPPGA window decal

Current Membership List

Standing invitation to attend all Association meetings for education and to join in networking,

 sharing ideas, etc. (Held quarterly)

C.P.P.G.A. Newsletter, “Groomer’s Newsline”

Updates on current and proposed changes in the state and local

Legislation regarding pet care and grooming issues

The Colorado Professional Pet Groomers’ Association’s

New membership fee is $44.00

The annual renewal fee is $34.00

Please do not send cash. Make your check payable to CPPGA and

Mail it with this application to:

CPPGA, P.O. Box 1211, Arvada, CO, 80001-1211

CPPGA is an educational organization and is not responsible for individual members’ actions or business practices and decisions.