| Member Information | |||
| Membership Type: | Nonmember | AKCA Member #: | |
| Tattoo Prefix: | Expiration Date: | ||
| Herd Prefix: | Maplewood | Member Since: | |
| Farm Name: | Maple Wood Farm | Renewal Date: | |
| First Name: | Jy and Gail | Last Name: | Chiperzak |
| Address: | RR4 | ||
| City: | Marmora | State/Region: | ON |
| ZIP/Postal Code: | Country: | Canada | |
| Phone 1: | Phone 2: | ||
| Email Address: | |||
| Web Site: | |||
Member ID # 116