MEMBERSHIP RATES--Please choose one:
    
Heifer Grower Membership: $199.00
Additional General Membership: $129.00 (nonvoting rights)
Associate Member: $129.00
Student Membership: $39.00
  

Check for membership enclosed

Charge membership to my credit card 
(MasterCard or VISA)

Signature: _________________________________________________

2. Job Responsibility (check all that apply)

Grower   Dairy Producer   Consultant Researcher

Extension  Veterinarian  Trade Journalist   Industry Representative 

Farm Employee      Other  

3. Age Groups Raised & Farm Capacity (number of head)

Baby Calves (day old through weaned; 300 lbs.)   
Adolescent Heifers (weaned through breeding age)
Springers (bred through pre-calving)                     
Others (e.g., bulls)

4. Financial agreements available (check all that are available)

Contract (Dairy producer retains ownership)
Livestock for sale
Purchase - First option buy back
   Other (please specify)

5. Information Release:

Do we have your permission to have this information printed in the DCHA Membership Directory, which will be made available to DCHA members and can be purchased by nonmembers? 

 Yes No

6. Do we have your permission to post your information on the Members Only section of the DCHA website? 

 Yes No

7. I have the "Raising Quality Replacement Heifers--A Guide to Best Management Practices" and have reviewed it with my staff and veterinarian. 

 Yes No

8. I have participated in the voluntary third-party audit. (DQA Dairy Quality Assurance^SM FIVE-STAR Program.)

 Yes No

[Important Note: Unless specifically prohibited, a DCHA member's name, address, and phone number will be printed in the Membership Resource Directory. If this survey is not returned, the information we presently have in our membership database will be used.]

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