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Mississippi Cattle Dog Association 2004

Membership Application

(Please Print) Paid By: CASH______or CHECK

Name: __________________________________________ Family Membership:____

Address: ________________________________________ Single Membership: ____

City: _________________________________ Renewal: ______

State/Zip: ___________________________________ New Member:_____

Phone (home)_____________________________ (work)________________________

E-mail Address: ____________________________________________

 

Family Membership$25.00

Single Membership.$20.00

Please include annual membership dues with signed application and mail to:

Mississippi Cattle Dog Association

C/O Trudy Bush

741 Kalem Road

Morton, Mississippi 39117

I (print name) ______________________________, will not hold Mississippi Cattle Dog Association, any officer, board member, member, worker, landowner or livestock owner liable for an accident, injury, death or damage to myself or any of my property. I enter this agreement at my own risk.

Signature________________________________Date_________________

 

Trudy Bush, Secretary/Treasurer (601) 732-2284

E-mail U2Clean@aol.com

 
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