ARKANSAS PORK PRODUCERS ASSOCIATION
ALLIED ASSOCIATE MEMBERSHIP FORM

FARM OR COMPANY NAME ______________________________________________________________


CONTACT PERSON ______________________________________________________________________


ADDRESS _______________________________________________________________________________


CITY ______________________________________ STATE _________________________ZIP___________


PHONE _________________________________________ FAX____________________________________


EMAIL ADDRESS _________________________________________________________________________



TYPE OF MEMBERSHIP

____________________ $100 BRONZE MEMBERSHIP

____________________ $250 SILVER MEMBERSHIP

____________________ $500 GOLD MEMBERSHIP

____________________$1000 PLATINUM MEMBERSHIP

MAIL TODAY TO:

ARKANSAS PORK PRODUCERS ASSOCATION
625 BUCK MOUNTAIN ROAD
DOVER, AR 72837
(479) 331-9708
(479) 331-9709 FAX
arkpork@yahoo.com EMAIL