North Carolina Cattlemen's Association
Membership Application

Name _______________________________________________________________________

Firm or Farm Name _________________________________________________________

Address _____________________________________________________________________

City _______________________________  State _______    Zip _____________________

County ___________________________________________

Telephone Number ________________________________

E-mail Address ____________________________________

Recruited By ____________________________________

Please indicate type of membership:

_____  N. C. Cattlemen's Association for one year - $25.00

_____  N. C. Cattlemen's Association for five years - $100.00

_____  N. C. Cattlemen's Association Lifetime Membership - $300.00

Payment Methods:

_____  Check - made payable to N. C. Cattlemen's Association

_____  MasterCard               _____  Visa               _____  Discover

Name on Card ___________________________________________

Card Number ______________________________________________

Expiration Date __________________________

Signature _________________________________________

Please return application along with payment to:

N. C. Cattlemen's Association
2228 N. Main Street
Fuquay-Varina, NC 27526
(919) 552-9111
(919) 552-9216 - FAX