IMPA Membership Application

Membership Application

1701 Towanda Avenue, Bloomington, IL 61701
NOTE: Cooperative members of Dairy Farmers of America, Foremost Farms USA, and Prairie Farms Dairy, Inc., are represented by their co-ops (Class A [voting] members). Dues are paid by each cooperative association.
Please check your category of membership:*

Class B: [voting] members consist of individual producers of dairy products who are not members of a dairy cooperative which is a Class A member (see note above).Class D: [non-voting] members consist of for profit dairy-related industries and professions.Class E: [non-voting] members consist of non-profit associations and college university departments involved in issues affecting the dairy industry.Class F: [non-voting] members consist of individual persons not engaged in production of dairy products but who are employed by or affiliated with government agencies or university departments.
Please remit dues associated with membership category checked above:*

Class B: [voting] – $0.50/cow/yearClass D: [non-voting] - $250/member.Class E: [non-voting] - $100/member.Class F: [non-voting] - $25/member.
Number of Cows:
Total Class Dues Amount Due:
Name of Business*
Contact Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty: