Sale Issue 2015
31
Columbia Membership Form
This form is easy to fill out online:
This form has been created to best serve the Columbia membership
in providing up-to-date contact information that you would like for
each membership in the Breeders Directory. The form
must
be filled
out for each membership in future Breeders Directories. It is only
necessary to fill the form out once, unless a change is needed in
your contact information.
Membership
o
Existing
o
New Member
Membership Type
o
Senior Membership
o
Junior Membership
Online Directory
o
Include me in the free online directory
o
Do not include me in the free online directory.
Name:_ _____________________________________________
Farm Name:_________________________________________
Address:____________________________________________
City:________________________________________________
State:_______________________ Zip Code:_ _____________
Phone:______________________________________________
Cellular Phone:______________________________________
Daytime Phone: _____________________________________
Fax:_ _______________________________________________
E-mail Address:_____________________________________
Web site:_ __________________________________________
Please return to the Columbia Association Office.
