Name___________________________________________________________________
Farm/Business Name________________________________________________________
Address_________________________________________________________________
City, State, Zip____________________________________________________________
County_______________________________Phone______________________________
E-mail__________________________________________________________________
q New      q Renewal
Recruited by_____________________________________________________________

Individual Dues $40  

$__________________________

  Fair Share + .10 per    head

$__________________________

County Dues (if applicable)                 

$__________________________

Lifetime Membership $500

$__________________________

Choice Stockman Member
$100 to $499

$__________________________

Allied Industry Member $500+

$__________________________

CattleWomen's Association $20

$__________________________

Junior Cattlemen's Association  $15

$__________________________

Each additional junior family member $5

$__________________________

National Cattlemen's Beef Association
0-50 head            $50.
51 to 100 head      $80.
101 to 250 head   $120.
251 to 500 head   $200.
501 to 1000 head $300.
+ fair share
1001 to 1500 head $450.
+ fair share
1501 up head        $600.
+ fair share
   Fair Share is $.20 per Cow/Calf;  $.10 per stocker      
   Note: MCA is handling the NCBA memberships now. Please remit NCBA dues to MCA on this statement      

NCBA dues   $________

fair share      $________

TOTAL

$__________________________

q VISA     q MasterCard

No.______________________________________________________________________
Exp. Date_________/____________/___________
Cardholder's Name__________________________________________________________
                                                               (Please Print)

Signature__________________________________________________________________