JOIN PBA -- Membership and Herd Name Registration Request Form

Complete this form if you would like to join the Pygora Breeders Association (PBA).

Membership Benefits are:

• quarterly subscription to the PBA Newsletter

• lower cost to register animals

• lower cost to place ads in the PBA Newsletter

• being listed on the online Membership List (only for Family memberships)

• ability to vote in all elections
  being a committee member to have your voice heard (we like diversity therefore we encourage members from all areas in the country to be active in committees)

• you can also for an additional one time fee of $5 secure your herdname/tattoo designation for life

• participation in our online board meetings expressing your needs, wants and hopes for PBA

It is easy to join, just select the appropriate membership type (Family or Youth), provide your name and phone and click "Add to Cart". Note: PBA will use your PayPal billing address. Please include any address changes in the notes section during the PayPal checkout.
 

Membership Contact Information -- Fill in all applicable fields:
* denotes a required field, you can not continue if you do not enter data in these fields

SPAM Stopper:  *	UPDATE: PBA has been getting a lot of spam from internet bots.  To limit the SPAM you must type the word shown in the graphic below in the field above or you will not be able to submit this form.  We're sorry for any inconvenience this may cause you.
Type of Membership: *	Family Membership — $20 (One family and one vote)  Youth Membership — $10 (Up to age 18 and no vote)   — If you select youth, you must provide your date of birth
Your Name (s): *
Address: *
City: *
State: *	Select Your State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip: *
Phone(s): *
E-mail: *
Web Site:
Member Web List	Would you like your information published in the online member list? Note: this option is only available for Family members. Note: All information expect Website will be published. This is an all or nothing listing. Yes No
Herd Name Registration: *	Required before registering your farm’s offspring Yes, I want a Herd Name — $5 No, I do NOT want a Herd Name — $0 Note: Please provide us with a 2nd choice of both herd name and tattoo letters, in case your 1st choice is already in use. Herd name and tattoo letters will belong to you for life.
Herd Name (1st choice):
Herd Name (2nd choice):
Tattoo (1st choice):	note: Tattoo's should be up to 3 letters
Tattoo (2nd choice):	note: Tattoo's should be up to 3 letters
Payment Method: *	PayPal Check or Money Order via Postal Mail