NAME(S)___________________________&________________________________________

CHILDREN'S NAMES AND AGES__________________________________________________

___________________________________________________________________________

ADDRESS____________________________________________________________________

CITY______________________ STATE/ZIP _______________COUNTY_________________

PHONE_____-_____-___________ E-MAIL_________________________________________

FARM NAME _________________________________________________________________

TYPE OF CATTLE RAISED, OR BEEF RELATED BUSINESS OR INTERESTS_________________

DIRECTIONS TO FARM__________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

DUES:      $75 / 5 years          $250 / LIFETIME

COMMITTEES OR ACTIVITIES I (WE) WOULD BE INTERESTED IN HELPING WITH:
MEMBERSHIP       FUNDRAISING       SALE       PROMOTION       EDUCATION
SHOW       BANQUET       DIRECTORY       NEWSLETTER       ADVERTISING

COMMENTS_________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________