WBGA Member Registration

WBGA Member Registration
Date

MonthDayYear
Date
Contact Name

First NameLast Name
Business Name
Please put N/A if not applicable.
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Farm Location (if different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Phone Number

Area CodePhone Number
Hotline/Other:

Area CodePhone Number
County
Email
example@example.com
Website
Facebook
Twitter
Check here if you DON’T want to be listed on WBGA website or promotional materials.
Berries You Grow

BlueberriesStrawberriesRed RaspberriesPurple RaspberriesBlack RaspberriesSummer Bearing RaspberriesGooseberriesCurrantsOther
Grower Members

Dues are $100 base fee, plus an additional $11/bearing acre - Maximum member dues not to exceed $250
Bearing Acres
Member Fee Due
Additional Membership Types

Associate Member: $125 - Industry related company membershipsFriend Members: $25 - Retired members of WBGA; University & Extension personnel; Not-for-Profit Ag. Organizations; TradePublications; (places you on the mailing list and Fresh Magazine)
Where would you like your contribution focused?

EducationalResearchMarketing
How did you hear about us?

Rack CardPost CardWebsiteSocial MediaWord of MouthOther
Total Fees Due
Discount Applied

A $20.00 Conference Discount has been applied to your total.
Payment Method

Mail PaymentPay Online
Checks Payable to:
WBGA

Mail to:

WBGA
1255 S Westhaven Dr,
Oshkosh, WI 54904

Email:
info@wiberriesandveggies.com

Phone:
608-692-2748
Credit Card Calculation

Should be Empty:

WBGA Member Registration

Discount Applied

Credit Card