Simian Society of America, Inc.
Simian Society of America, Inc.

Simian Society of America, Inc.


Providing Information for a Lifetime of Care







Nonhuman Primate Help:







Application for Membership
I wish to make application for membership in The Simian Society of America.  
 ____ New    _____Renewal
______ Active Membership [Available to those who currently own or previously owned and care for nonhuman primates at the discretion of the Board.] (“Caring” shall be defined as providing housing on your premises, feeding, maintenance, and veterinary care of captive non-human primates.) 
Classes of Membership:
Individual $40.00
Spouse $10.00  (Same address/no publication. May be purchased only in conjunction with an individual active membership. Husband, wife or life-partner  ONLY)
Life* (active membership only) $750.00
(*Life memberships may not be transferred to another person and are non-refundable.)
Membership is renewed each July. New members joining January – June, pay for a full year PLUS the prorated amount of the remainder of the year.
 Contact the Membership Chairman for the total due. The Membership Chairman can be reached at or by phone 803-646-2797.
Allow four to six weeks for first delivery.
All dues to renew each July.  Contact Karen Betow for amount due.
Additional donations may be made to the following funds:
$________  PHN  (Primate Health Network)     $________  LHPP (Lu Hall Primate Placement)
$________  Legislation
$_________  General Fund
$________ Education Department
$_________ Publications                
$________  In Honor or Memory of________________
PLEASE PRINT CLEARLY. All information you provide will remain confidential.
NAME  ____________________________________________
ADDRESS  ____________________________________________
CITY ___________________________________ STATE  ________ ZIP __________
PHONE (H) ______________________  
(W) _________________ (C)___________________
FAX  (H)  _________________________
(W) ______________________________
EMAIL ADDRESS  ____________________________________________
Occupation ____________________________________________
Designated Home Chapter   _______   Member of other Chapters, which ones?  ___________________
Reference #1/Reference #2
Name: ________________________________
Name: ________________________________
Email:  ________________________________
Email: ________________________________
Phone: ________________________________
Phone: ________________________________
·Required to be considered for membership. 
1.Do you currently own and care for nonhuman primates? (“Caring” shall be defined as providing housing on your premises, feeding, maintenance, and veterinary care of captive non-human primates.)
Yes     No
Please list below the primates in your care (specific species, name, age, sex, year of birth, or approximate age if birth date unknown):
2.Have you previously owned and cared for or have a direct working relationship with a nonhuman primate?  Yes    No
 Please explain in detail: ____________________________________________
* Applicants meeting one of these criteria may be issued an active membership at the discretion of the Board. Membership for this category will be reviewed each year.
Please list Name, Clinic name, Address and Phone Number, and email address of your Veterinarian that treats monkeys:
Are you involved in or a member of, or affiliated with any individual, group, or organization that is working to create bans of private ownership of nonhuman primates? Yes No
If yes, please explain in detail:
I declare that I have reviewed all information on this application and have answered all questions truthfully and correctly. I understand that the SSA reserves the right to refuse or revoke my membership at any time according to the bylaws. I have read and agree to the terms of membership.
Signed: __________________________________ date: _____________________
Please complete and mail with your check to
Karen Betow
230 Science View Dr.
Clinton TN 37716
Enclosed please find my check in the amount of $______________, payable to the Simian Society of America, Inc. Membership may be paid through PayPal.  If using PayPal, there is a $2 processing fee.  
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