Application For Membership

Full Name:

 Mr  Mrs  Ms  Miss

Postal Address:

Phone:

Fax: 

Mobile:

Email:

Nominee for Membership:


(only required if the membership is not in an individual name)

Date of Birth:

  DD/MM/YYYY     (only required for Junior Membership)

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.  

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 a
breeder's letters or symbol placed in the cow or bulls left ear.

 

Signature:

 ________________________________    Date: ___________________________

 

Please forward this application form and cheque/money order for the appropriate amount (see fees schedule)
 Post to: Australian Belted Galloway Association Inc., PO Box 189, Kiama, NSW 2533