PENNSYLVANIA DEER FARMERS ASSOCIATION
MEMBERSHIP APPLICATION
(Please check one)
❑ New
❑ Renewal - Member #____________ (if known)
Membership Name:___________________________________________Date________________
Farm Name:_____________________________________________________________________
Address:________________________________________________________________________
City:_______________________State:_______Zip:_____________County___________________
Phone #1 (will appear in directory) ________________________ Phone #2:______________________
Fax:____________________________E-mail:__________________________________________
LOT
Website_________________________________________________________________________
IMPORTANT Please check all that apply: ❑ Farm ❑ Hunting Ranch Ranch Name & Contact info if different from Farm:
I am joining as (please check one) ❑ Active PA Propagator * (voting privileges) - $100.00 ❑ Associate Member (non-voting) - $75.00 ❑ Life Member * (voting privileges) - $1,000.00
*Must be a Pennsylvania resident
❑ Other _________________________
I hereby make application to the Pennsylvania Deer Farmers Association, Inc. and certify that the information I have provided is true and correct to the best of my knowledge.
Signature:___________________________________________ Date:______________________
Please mail application with payment to: PA Deer Farmers Association P. O. Box ÎÈÎxÊUÊ7>ëÀÌ]Ê*Ê£ÇÇä£ Please mail application with payment to: PA Deer Farmers Association P.O. Box 516 Fogelsville, PA. 18051
Payment method: Check (made payable to PDFA) - #__________________ Credit Card - ______Visa ______Master Card ______Discover
Card # __________ - __________ - __________ - __________
Expiration Date _____/_____ 3-digit V-code __________
(Please print clearly)
________________________________________________________________
_______________________________________
Credit Card Authorized Signature
Credit Card Billing Zip Code
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