Application for Membership

TO:

Charolais Breeders New Zealand (Inc)
P O Box 503
FEILDING

I hereby wish to apply for - (circle one)

Breeding Membership Associate Membership Junior Membership

1) Name (in full - please print): ...................................................................................

2) Postal Address: ...........................................................................................................

...........................................................................

3) Telephone:(....)..............................................

Fax:(....)..............................................

Mobile:....................................................

Email:.........................................................

AHB No:.......................................

4) Membership Name: ...................................................................................................

5) Membership Fees : Herd Registration Fee $56.25 GST incl

Breeding Subscription $168.75 GST incl.

Associate Subscription $28.13 GST incl

Junior Subscription $5.63 GST incl

a) I hereby agree to abide by the rules, regulations and by-laws of the Charolais Breeders New Zealand (Inc).

b) I consent to including my name and address in any published membership list or providing my name and address as a Charolais breeder or Member to any third party at the discretion of the Society.

Signed: .................................................
(New Member)

Signed: ............................................... Signed: ................................................
(Nominating Member) (Nominating Member)

=======================================================

HERD RECORDS

Please complete the following information:

I wish to register my

Prefix: 1^st choice.................................................... 2^nd choice............................................

3 digit Tattoo : 1^st choice........................................ 2^nd choice............................................

(Please give an alternative choice)

BREEDPLAN

I wish to record my herd on the Breedplan pedigree & performance recording system.

Signed:.........................................................................................