PBA Membership / Herd Name Registration Request Form

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JOIN PBA -- Membership and Herd Name Registration Request Form

Complete this form if you would like to join the Pygora® Breeders Association (PBA) and pay with PayPal only, if you do not complete the PayPal payment your request will be disregarded. A convenience fee will be assessed.

To pay by check complete the Mail In -- Membership Application and Herd Name Registration Form.

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.
Membership Status: *	New Member Renew my current Membership Note: If you would like to renew for more than one year, enter the number of years in this box:
Type of Membership: *	Family Membership — $25 (One family and one vote) Youth Membership — $15 (Up to age 18 and no vote) — If you select youth, you must provide your date of birth
Your Name (s): *
Address: *
City: *
State: *
Zip: *
Country: *	Note: Canada and Overseas includes an extra $5 USD. Please contact the PBA registrar with your correct address at PBARegistrar@aol.com
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 memberships. Note: All information except 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 — $10 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 only, if you do not complete the PayPal payment your request will be disregarded.

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