Membership Application

____    I want to be a DBCAA Voting Member and qualify for discounted registration fees.  Enclosed is $25 Lifetime Membership.  (Subject to annual $15 activation/Bulletin subscription fee.)  I own #_____ registered and/or #_____ breeding up recorded cattle.

____    I am a Lifetime Member, enclosed is my annual $15 activation/Bulletin subscription fee.

____    I enclose $15 for annual Associate Membership (non-voting) to keep in touch with DBCAA through the Dutch Belted Bulletin. Foreign add $15/year.

Note: You may subscribe for more than one year at a time, eg. $45 for three years.
Membership is based on annual subscriptions beginning in January. If joining midyear, contact secretary for prorated membership.

____   Please send applications for registration of my purebred or breeding up cattle.

Name: ___________________________________     
Address: __________________________________            
Phone: ____________________________________

E-mail address: _____________________________

Please make payments out to DBCAA.

Mail to: DBCAA
c/o Kristine Haag
15470 N 3400 East Road
Cullom, IL 60929