Pet Sitters Associates, LLC. - Membership Application

Application For Membership

This form will need to be printed and mailed to: Pet Sitters Associates, LLC 2924 Northwinds Dr., Eau Claire, WI 54701.
Please fill in all of the fields and click the "Print Application" button. A new window will open with your completed printable version of this application.

Please do not send the application certified mail, we are not in the office to sign for mail when it arrives.

Your startup packet and ceritificate of membership will arrive in the mail two to three weeks after you mail out your application.
There is a $20 fee for any returned check.

Personal Information

Individual Name:

Spouse's / Partner's Name:

Mailing Address:

City:

State:

Zip:

Phone Number:

() -

Fax Number:

() -

Employees / Independent Contractors:

Additional Insured's:

(landlord, management company, convention, park, aPaws, not a person who works for you)

Business Name:

Website:

(http:// must be included before your website address
leave blank if you do not have a website)

Email Address:

(leave blank if you do not have an email address at this time)

Membership Dues

Individual Member:

$ 164

Spouse as additional member:

X $80

Partner's number:

X $80

Employee's number +
Independent Contractors:

X $80

Additional Insured's:

X $15

Special property of others coverage:
$10,000 Per Occurrence / $25,000 Annual Aggregate

$95

Dog / Pet Day Care:
start with supplemental application or
check the box to add the app to this page

If Eligible: $155

Grooming Coverage:

$100

Online Listing at
PetSitFinder.com:

$10

Total:

$500 per occurrence deductible for any claim arising out of the voluntary releasing
of a pet in your care, custody or control from it's leash, other than in the confined
premises of the pet's owner's or pet sitter's residence.

Your membership dues are fully earned.

Start Date:
(Your membership may begin the date your application is postmarked or later.
Please specify when you would like your membership to begin.)

(you must then sign and mail the application to the address listed above)

If you would like to fill them out manually, you can also download the printable questionnaire and printable application.