ALASKA LIVESTOCK PRODUCERS ASSOCIATION
PERSONAL INFORMATION
Date
/
Month
/
Day
Year
Date
Full Name
Phone
Address
Email
example@example.com
City State zip
How many cows do you own? Must be at least one (1).
Have you completed the BQA certification? Please send proof to akstockmen@gmail.com or mail to PO Box 1370, Delta Junction, AK 99737
Yes
No
PAYMENT INFO
Payment options
Cash (send to
Check- Mail to Alaska Livestock Producers Association at PO Box 1370, Delta Junction, AK, 99737
Credit card: Fill out the information below
My Products
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Membership
One (1) year membership. Expires December 2025
$
100.00
Signature
Payment Methods
Debit or Credit Card
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the form.
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