Pig Breeders Membership Application

APPLICATION FOR MEMBERSHIP

NAME ..........…………………………………………………...............................................

ADDRESS …………………………………………….........................................................

PHONE: ..........……………..... FAX: ............………..... EMAIL: ……………….………..

Hereby make application for admission as:

* ORDINARY MEMBER * LIMITED MEMBER (only eiligible to register 5 animals), ASSOCIATE MEMBER * JUNIOR MEMBER

(DELETE THOSE NOT APPLICABLE)

of the Australian Pig Breeders Association Limited (Known as "The Association"). I further agree to abide by the Articles of the Association.

DESIRED STUD PREFIX AND TATTOO BRAND

PREFIX TATTOO BRAND OR EARNOTCH

...................…………………….... ...................……………………....

(It is suggested that applicants provide three alternatives of preference for both Tattoo Brand and Prefix and that the Tattoo consists of three letters only).

In event of this Association is wound up whilst I am a member or within 1 year after I cease to be a member, IT HEREBY UNDERTAKE AND GUARANTEE to contribute to the property of the Association for the payment of its debts and liabilities such amounts as may be required, but not exceeding $20.00.

Signature of Applicant .........………………………...........................

Dated this ..................day of …………................. 20….

Membership Application Form

I/We hereby apply for (please select one) membership of the Australian Pig Breeders 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:

Region:

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: only required for Junior members

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 sow or boar's left ear.

Australian Pig Breeders
PO Box 189
Kiama, NSW, 2533

Phone: 02 4232 3333
Fax: 02 4232 3350
pigbreeders@lbcentre.com.au

Pig Breeders Australian Pig Breeders Association Information Membership Application Registration

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Australian Pig Breeders Association Limited

ABN: 26 905 086 209

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