LCA Membership Application/Renewal
To apply or renew your membership please complete all questions.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Phone Number
*
-
Area Code
Phone Number
E-mail
*
Parish
*
Recruited by
Membership Options (*Please choose one parish ONLY.)
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LCA MEMBERSHIP
$
50.00
Select Box for Parish with Dues of
$
5.00
Select Parish
Bienville
Cameron
Concordia
Grant
Iberville/WBR
Livingston
Pointe Coupee
Rapides
Red River
Sabine
St. Charles
Terrebonne
Union
Vermilion
West Feliciana
Winn
Select Box for Parish with Dues of
$
10.00
Select Parish
Acadia
Ascension
Bossier
Calcasieu
Caldwell
Catahoula
Delta
DeSoto
EBR
East Feliciana
Iberia
Jackson
Jefferson
Lafayette
Lafourche
LaSalle
Ouachita
St. Helena
St. Landry
St. Martin
St. Tammany
Southeast
Tangipahoa
Washington
West Carroll
Select Box for Parish with Dues of
$
15.00
Select Parish
Jeff Davis
Lincoln
Natchitoches
Select Box for Parish with Dues of
$
20.00
Select Parish
Beauregard
Franklin
Morehouse
Webster
Select Box for Parish with Dues of
$
25.00
Select Parish
Claiborne
Select Box for Parish with Dues of
$
30.00
Select Parish
Allen
Avoyelles
Richland
Fair Share .50/head
$
0.50
LCA uses these funds for youth & adult education.
# Head of Cattle
Family Membership
$
25.00
Quantity
Item subtotal:
$
0.00
PAC Donation
$
1.00
Amount $
NCBA Membership
$
150.00
Total
$
0.00
LCA Membership is
*
New
Renewal
Notes:
Submit Application
Should be Empty: