Please print and mail to WCA, PO Box 96, Ellensburg, WA 98926. Thank you!!!

 
NAME (FIRST & LAST):
 
SPOUSE'S NAME:
 
BUSINESS NAME:
 
MAILING ADDRESS:
 
CITY:
  
STATE:
 
ZIP: 
  
HOME PHONE:
 
WORK PHONE:
  
FAX:
 
E-MAIL:
  
RECRUITED BY:
 
COUNTY AFFILIATION:
 
EXTRA COUNTY:  
BREED: (voting members only)
 
 
Please check appropriate box:  
Voting Memberships:
Individual Voting Memberships
($75, plus 20 cents/head cattle >50 head)
Joint Membership (husband & wife only)
($125, plus 20 cents/head cattle >50 head)
 
Number of head
       
Associate Memberships: (no cattle)
Choice Membership ($300)
Allied Industries Membership ($200)
Select Membership ($100)
Regular Associate Membership ($50)
Student Membership ($35)
Date of Birth: (student members only) (Must be under 23 years of age)
 
TOTAL AMOUNT TO PAY:

Method of Payment:    

Check # ________

Credit Card

    
NAME AS APPEARS ON CREDIT CARD:  CREDIT CARD NUMBER:   EXPIRATION DATE:
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