Galloways Australia Inc Membership Application

I/We hereby apply for FullAssociate (please select one) membership of the Galloway Cattle & Beef Marketing Association and agree, if accepted, to pay forthwith the appropriate subscription fees and during my Membership to abide and be bound by the Rules/Regulations of the Association for the time being in force and by all by-laws made thereunder.

Title:

Given name or initials:

Surname:

Postal address:

Suburb/Town: State: Postcode:

Residential address 
(if different):

Suburb/Town: State: Postcode:

Phone: Fax: Mobile:

Email:

Nominee: Only required if membership is in the name of two initials eg. J.K. & L.M. Bloggs - J.K. Bloggs is the nominee

Date of Birth:12345678910111213141516171819202122232425262728293031JanFebMarAprMayJunJulAugSepOctNovDec

New password: Verify password:

Stud prefix: 1): 2): 3): In order of preference - please keep to no more than two (2) words. Note: In general a Stud Prefix is the name of a breeder's property and when registered, is to be placed before the name of each animal bred in the stud.

Tattoo Brand: 1): 2): 3): in order of preference - three (3) letters maximum. Note: A tattoo brand is a distinguishing mark in the form of the breeder's letters or symbol placed in the cow or bulls left ear.