Membership Form

Tell us a little about yourself
Name
First Last
Family Members (if applying for family membership)
Please list family members and ages of your children
Mailing Address*
Street Address City State / Province / Region ZIP / Postal Code
Home Phone
Cell Phone
Email*
Website

Now let's get some info about your farm
Farm Name
Desired Herdname
Your herdname is what goes in front of the goat's name when registering, you have 35 spaces including the herdname.
Herdname 2nd choice
We will always use the first choice if available; however, please list a 2nd choice as an alternative.
Tattoo Initials
This is your herd ID. We can choose one on your behalf if you are uncertain.
2nd Tattoo Choice
3rd Tattoo Choice

Additional signer: For Lifetime or Individual memberships ONLY! (Optional)

List name and email and/or phone for an additional signer in the event of incapacitation/death of membership holder
Would you like your membership information posted on the MDGA website?*
- Yes (Only the city and state will be listed.)
- No
Would you like your Phone number listed?
- Yes
- No
Which number(s)?
Would you like your website listed?
- Yes
- No
If you would like an email listed, please enter it below:
Section Break
How did you hear about MDGA?
Comments

Tell us a little about yourself