Virginia Poultry Federation - Membership Application

Virginia Poultry Federation Membership Application

YES, I WANT TO JOIN THE UNIFIED VOICE OF VIRGINIA'S POULTRY
INDUSTRY. SIGN ME UP TODAY!

All fields with and asterisk (*) are required

Please check the boxes next to the membership options you desire:

Allied Partner joining for $1000.00/year

Allied Supporter joining for $500.00/year

Associate Firm joining for $250.00/year

Friend of the Federation for $50.00/year (Smaller businesses and individuals)

Grower joining for $30 (½ off for the 1^st year) and $60.00 in succeeding years

* Contact Name

* Farm / Company Name

* Address

* City

* State

* Zip Code

* Phone Number

Referred by

Contracting with
(if applicable)

* E-Mail Address

(This is the email address that will be used for all correspondence from VA Poultry Federation)

Proudly serving Virginia's poultry and egg industries since 1925