Clone of ANDDA MEMBERSHIP APPLICATION

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Individual Membership$15.00
Voting Member

Additional Family Member$5.00
Non-Voting Member; individual account required

Youth Member$5.00
Under 21, non-voting; requires an individual account

Quantity

Total $0.00
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Individual Member Name
Last Name, First Name
Additional Family Member
Spouse, Partner, Additional Household Member
Number of Youth
NUMBER MUST MATCH NUMBER IN SHOPPING CART
Youth Name
Last Name, First Name
Date of Birth
Youth Name
Last Name, First Name
Date of Birth
Youth Name
Last Name, First Name
Date of Birth
Youth Name
Last Name, First Name
Date of Birth
Youth Name
Last Name, First Name
Date of Birth
Youth Name
Last Name, First Name
Date of Birth
Herd Name
N/A if no herd name
Website address
N/A if no website
Email
example@example.com
Phone Number
COUNTRY
Address
Street Address
City
State
US Zip Code
0000 if 4 digit unknown
Province
Canadian Zip Code
0000 if 4 digit unknown
DHIA Member - my herd is on DHIA Testing
Farm Logo for Website

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Facebook Membership Name (for ANDDA Discussion Page)
type NA if not on Facebook
MEMBERSHIP DIRECTORY

ANDDA publishes Member's name, and any associated names, herd name, phone number, email address, website address, city, and state to the Members Directory, sorted by state and herd name.
Member Directory:
Calendar Mailing Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
COMPLETE APPLICATION BY HITTING SUBMIT BELOW:
DISTRICT
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