Come Join Us!

Please fill out the information below, print and send with your dues to

John Pfeiler, Treasurer

PO Box 181

Bloomfield, NY 14469

Our membership year is from March 1^st through the last day of February. Dues are $10 for the first family member, $7 for each additional member of the household. For an additional $10 you can enclose your business card to be run in the newsletter during your membership year. Please make checks payable to NYSDGBA.

IS YOUR MEMBERSHIP (circle) New Renewal Adult Youth (<16)

NAME_____________________________________________________

ADDRESS__________________________________________________

CITY__________________________STATE_______ZIP____________

PHONE(____)________________FAX(____)______________________

COUNTY___________________EMAIL__________________________

HERD NAME________________________________________________

WEB SITE__________________________________________________

BREEDS (circle, put a * by any with available buck service)

ALPINE LAMANCHA NIGERIAN NUBIAN OBERHASLI REC GRADE

SAANEN SABLE TOGGENBURG OTHER_______________________

STOCK FOR SALE? Yes/No BOARDING AVAILABLE? Yes/No

AI? Yes/No FOR OTHERS? Yes/No CAE PREVENTION? Yes/No

PRODUCTS FOR SALE?______________________________________

DO YOU PARTICIPATE IN DHI TESTING? Yes/No SHOWS? Yes/No

LINEAR APPRAISAL? Yes/No 4H or FFA? Yes/No

ARE YOU A PAID MEMBER OF ONE OF OUR AFFILIATED CLUBS?

(please circle below)

CNYDGS ENYDGC FDGC GCDGC LIDGA NFDGA PDCG

SLVDGA 4H MEMBER/LEADER NDGHIA NONE OTHER____________