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| ABOUT 4-H | VOLUNTEERS |
For an interactive, printable version of this form, click here
ME Association of Livestock Exhibitors - Membership Application
Please print. Do not abbreviate. Membership year July 1, 2009 - June 30, 2010
| Today's Date: | This form is NOT proof of membership. | |||||
| Name Primary Member |
First Name | MI | Last Name | Birth Date | ||
| Spouse | First Name |
Last Name | Birth Date | |||
| Children Under age 18 Dependents 18 and over MUST have own membership |
First Name | Last Name | Birth Date | |||
| First Name | Last Name | Birth Date | ||||
| First Name | Last Name | Birth Date | ||||
| ___ Additional children listed on back | ||||||
| Mailing Address All mail sent to Primary Member |
Street: | |||||
| Town: | State: | Zip: | ||||
| Phone | Home: | Cell: | ||||
| Email: | ||||||
| Farm Name | ||||||
| Animals Exhibited | i.e. Beef, Dairy, Show Steers, Sheep, Swine, etc. Please list all commodities shown. | |||||
| Membership Type Requested | Family $35.00 Includes Head of Household, Spouse and/or
Children under age 18 Individual $20.00 Single person 18 years of age or over. Includes dependents age 18 and over. |
New Renewal |
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| Name/Address shared with Fairs? Yes___ No___ | ||||||
| Office Use Only | Amount Paid: | Date Received: Time: | ||||
| Card Sent: | Check # | Cash | ||||
We do not accept memberships under a business name.
Please make check to: Maine Association of Livestock Exhibitors
**Returned Check Fee: $35.00**
We do not accept debit or credit cards.
Send form and fee to: Maine Association of Livestock Exhibitors
Kathy Haskell, Secretary
9 Harriet Avenue
Windham, ME 04062
207-892-5396
Please allow 3-4 Weeks for processing
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