I hereby submit this application to the board of directors with my check made to the Alabama BCIA for the current year's activity.  Current year is July 1 through June 30.

__ I am a Commercial Breeder with the following number of cows:
           __1 to 50 cows $25.00
           __Over 50 cows $50.00

__I am a Purebred Breeder $50.00
 
                                                 Total Remitted $______________

For those producers who are both commercial and purebred breeders, please check all boxes that apply, but only pay one membership fee.  Please pay the higher level of the membership structure.  For example, if you have 25 commercial cows and 25 purebred cows, your dues would be $50.00.  If you had 100 commercial cows and also a purebred herd, your dues would be $50.00.

Name
FarmName
Address
City                                                         Zip                                              County
Telephone                                               Date

Signature
 

Mail to:
BCIA
40 County Road 756
Clanton, AL 35045