Date_____________________

Name:______________________________________________(please include your spouse)

Farm or ranch:________________________________________________________________  

Address:______________________________________________________________________

City:_____________________  County:______________  State:__________  Zip:_____

Phone:(       )_______________________   Fax:(       )________________________

E-mail address:_______________________________________________________________

Please check the following:

New member________  Renewal________  

Member of the National Bison Association(NBA)_________

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Please check each one that applies to your operation:

       _____Breeding Stock            _____Bull Calves        

       _____Heifer Calves             _____Yearlings

       _____Mature Bulls              _____Feedlot Bulls

       _____By-Products for Sale      _____Bison Hunts	       

       _____Organized Tours           _____Catering & Concessions

       _____Meat for Sale 
               _____Whole,halves & quarters 
               _____Retail packaged/processed 
               _____Wholesale P & P

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Our Farm/Ranch presently has: 

  _________Bulls   _________Cows   _________Calves   _________Yearlings

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Current dues are $35.00 and are valid through December 31 of each year.

Make checks payable and send to:
       IOWA BISON ASSOCIATION
       c/o Tammy Wedeking
       1350 250th Street
       Waverly, IA  50677