FLORIDA DAIRY GOAT ASSOCIATION MEMBERSHIP APPLICATION/RENEWAL FORM

****Make checks payable to FDGA and mail To:**** Kathy Autry, FDGA Treasurer, PO Box 431, San Antonio, FL 33576

Mail form to Judy Rummel, FDGA Secretary,410 NW 266th St.,, Newberry, FL 32669

PLEASE PRINT NAME: ____________________________________________

COUNTY: __________________________________________

ADDRESS: _________________________________________

CITY: _________________________ STATE: ___________ ZIP: _____________ PHONE: (_____)______________ E-MAIL: _______________________________

BREED(S) RAISED: ________________________________

HERDNAME: __________________

WEBSITE: ________________________________________

RENEWAL: Y_____ N _____ NEW MEMBER: Y _____ N _____

Would you like to advertise in our newsletter? Y _____ N _____ Please see advertising rates in this newsletter. NOTE: MEMBERSHIP DUES ARE $20.00 PER YEAR AND ARE DUE ON JULY 1ST AND RUN UNTIL JUNE 30TH THE FOLLOWING YEAR. What information, workshops and/or classes would you like to see offered by the Florida Dairy Goat Association? _______________________________________________________________ _____________________________________________________________________________

Would you like to receive your newsletter via the internet versus a hard copy mailed to you? Postage and printing cost only continue to rise. If you can possibly obtain your newsletter via the internet, please indicate so. Thank you. Y _____ N _____

To have your herd name listed on the FDGA web site, your signature is required below:

PRINT: ________________________ SIGNATURE: _________________________ DATE: ______

DUES @ $20.00 PER YEAR $ __________________ ADVERTISEMENT IN NEWSLETTER $ ____________ (See website at fdga.org for rates) TOTAL ENCLOSED: $ _____________________