PBA Breeders Directory Request Form

Breeder Directory Info $15 per year (including first 75 words, $15 for additional words up to 75 more)

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: *

PBA has been getting a lot of spam from internet bots. To limit the SPAM you must type the word GOAT in the field above or you will not be able to submit this form. We're sorry for any inconvenience this may cause you.

PBA Membership Number: *

Your Name (s): *

Herd Name:

Tattoo:

Address: *

City: *

State: *

Zip: *

Phone(s):

Fax:

E-mail:

Web Site:

Number of Pygoras:

Doe: Buck: Wether:

Services:

Breeding Stock (BR)	Other Livestock (OL)
Fleece (FL)	Product Sales (PS)
Fleece Processing (FLP)	Promotional & Educational Materials (PR & ED)
Stud Services (SS)	Promotional & Educational Materials (PR & ED)

Comments:

(75 words included in cost, $15 for additional words up to 75 more)

Payment Method: *

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