Illinois Beef Association 2013 Membership Form

Your Current Information:

Farm Name:

Affiliate:

Recruiter:

Mailing Address:

First Name:

Last Name:

Address

Address2

City

State:

AL AK AB AZ AR BC CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MB MD MA MI MN MS MO MT NE NV NB NF NH NJ NM NY NC ND NS OH OK ON OR PA PE PQ RI SK SC SD TN TX UH VT VA WA WV WI WY

Zip:

Phone:

e-mail:

Mailing Address is the same as Billing Address

AL AK AB AZ AR BC CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MB MD MA MI MN MS MO MT NE NV NB NF NH NJ NM NY NC ND NS OH OK ON OR PA PE PQ RI SK SC SD TN TX UH VT VA WA WV WI WY

Type of Operation (check all that apply):

Auction Market		Backgrounder
Club Calf		Commercial Cow/Calf
Dairy		Feeder
Processor		Young Producers Council
Purebred (List Breed):

Membership Options (check 1 box only):

OPTION #1:..."IBA Membership Only"
50 Head or Less		$60
51-TO-100 Head		$95
101 Head or More		$140
OPTION #2:..."Agri-Business Membership"
IBA		$250
OPTION #3:..."Junior Membership Dues"
Junior Membership		$25

Fair Share (please enter # of cattle):

Active members are encouraged to pay fair share dues based on the number of cow/calf pairs, stockers/feeders owned annually or annual-one time capacity of feedlot cattle. Fair share dues go directly to IBA’s efforts to protect your rights as a cattle producer.

Cow-Calf Pairs:	# of head x $0.50 /head = Total:
Stocker/Feeder:	# of head x $0.25 /head = Total: $0.00

Family Membership:

… THIS IS IN ADDITION TO YOUR IBA MEMBERSHIP FOR YOUTH PROGRAMS

Includes up to 3 Jr. Memberships

$25

Add Another Name

Name of Junior Member:  

Add Another Name

Name of Junior Member:

Name of Junior Member:

NCBA Dues (Optional):

# of Head	Dues
up to 100	$100
101-250	$200
251-500	$300
501-1000	$400 + Fair Share*
1001-1500	$550 + Fair Share*
1501 & Up	$750 + Fair Share*
* Fair Share	# of Head	Price	Total
Cow-Calf: (Number of cow/calf pairs)		$0.25
Stocker/Feeder: (Number of beef or dairy cattle marketed)		$0.125
Annual Associate Dues (Non Cattle Owners / Non-voting)
Business Supporting Member	$150
Individual Supporting Member	$100
Student Membership	$50