Welcome To ZHA

Vendor Membership Application

To pay by check:

Please make check for $200.00 payable to Zebrafish Husbandry Association, Inc.

Mail to:

Vendor Membership, ZHA

2713 Jay Bird Court

Knoxville, MD 21758

To pay online by PayPal:

Please fill out the form below and click submit at the very bottom of the page.

Company Name:

Mailing Address:

City, State:

Zip Code:

Telephone Number:

As represenatative for the above listed vendor, I hereby apply for institutional membership in the Zebrafish

Husbandry Association, Inc. and agree to pay $200.00 as our annual dues for one calendar year.

First Name:

Last Name:

Two complementary memberships are to be assigned as follows:

#1 First Name:

#1 Last Name:

Position:

Email Address:

Mailing Address:

City, State:

Zip Code:

Telephone Number:

#2 First Name:

#2 Last Name:

Position:

Email Address:

Mailing Address:

City, State:

Zip Code:

Telephone Number:

Membership 1

Membership 2

Please note: The information submitted will be used for our member directory and will only be accessible to ZHA

members. If there is information you wish to be omitted in the membership directory please send your request to