Name:_______________________________________

Farm Name:__________________________________

Address:_____________________________________

City State Zip:_________________________________

E-Mail:________________________________________

Telephone:____________________________________



Breeds of Goats Owned:____________________________

_______________________________________________

Do you Show? YES or NO
Are you currently experimenting? YES or NO
DO you have a webpage? YES or NO

If yes URL:________________________________
Do you Want you information listed on the association webpage? YES or NO
Circle Which if yes. Name  Farm Name  Address  Telephone  E-Mail  URL