Application For Membership
Missouri Simmental Association
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Terri Belcher - 3939 North Route Z - Columbia, MO 65202

Application is hereby made for membership in the Missouri Simmental Association to be issued in the name of:

Member Name:__________________________________________

Farm Name (if applicable):__________________________________

My American Simmental Association Membership number is:________

I/We,________________________________________________ agree to abide by the Rules and Regulations, Constitution and by-laws of the Association as amended from time to time, and as interpreted and enforced by the Board of Directors or such committees as the Board of Directors may designate.
The undersigned applicant expressly agrees that the Board of Directors has and shall forever retain the exclusive and sole right to discontinue any member's membership whenever in the sole and unlimited discretion of said Board of Directors, any member shall be found to have failed to comply with any of the Association's Rules, Regulations, Constitution or By-Laws.

Enclosed is $35.00

Signed:________________________________________________

Address of membership:___________________________________
_____________________________________________________

Telephone:_____________________________________________

E-mail address:_________________________________________

Print and send to
Terri Belcher
3939 North Route Z
Columbia, MO 65202
573-474-8824