The undersigned herby applies for an Active Membership in the Minnesota Simmental Association, a non-profit corporation, with all rights and privileges and subject to the obligations thereof, as set forth in the Rules and By-Laws of the Association. In consideration
of the agreement to issue such membership, the membership fee is paid herewith.

Name of Membership ________________________________________________________

Date _______ Signature of Applicant ____________________________________________

Phone No. ________________ e-mail ___________________________________________

Street or Rural Address _______________________________________________________

City _____________________________________ State & Zip ________________________

County __________________________________ ASA # ____________________________