* indicates required field

Adults

1. Name
2. HFA#
3. Phone
4. Address
5. City
6. State
7. Zip
8. County Select One Adair Andrew Atchison Audrain Barry Barton Bates Benton Bollinger Boone Buchanan Butler Caldwell Callaway Camden Cape Girardeau Carroll Carter Cass Cedar Chariton Christian Clark Clay Clinton Cole Cooper Crawford Dade Dallas Daviess DeKalb Dent Douglas Dunklin Franklin Gasconade Gentry Greene Grundy Harrison Henry Hickory Holt Howard Howell Iron Jackson Jasper Jefferson Johnson Knox Laclede Lafayette Lawrence Lewis Lincoln Linn Livingston McDonald Macon Madison Maries Marion Mercer Miller Mississippi Moniteau Monroe Montgomery Morgan New Madrid Newton Nodaway Oregon Osage Ozark Pemiscot Perry Pettis Phelps Pike Platte Polk Pulaski Putnam Ralls Randolph Ray Reynolds Ripley St. Charles St. Clair Ste. Genevieve St. Francois St. Louis St. Louis City Saline Schuyler Scotland Scott Shannon Shelby Stoddard Stone Sullivan Taney Texas Vernon Warren Washington Wayne Webster Worth Wright
9. Email address
10. Prefix
11. I want to receive the Mid-States Holstein magazine *
    1. Yes (adds $5)
    2. No

1. Additional Members at Address (one name per line)

Associate Membership

1. I am registering as an Associate Member only (0 cattle ownership).

Juniors

Junior Membership $5 per junior per year (those under age 21 as of January 1).

1. First and last name
2. Birthdate (mm/dd/yy)

Questions

1. Would you like to be contacted regarding consigning to the Missouri Convention Sale?
   1. Yes
   2. No
2. Would you like to sell some Holsteins privately through the Missouri Association?
   1. Yes
   2. No
3. Would you like more information on advertising in the Mid-States Holstein News or the Pulsator?
   1. Yes
   2. No
4. JUNIORS: Would you like to compete at the National Holstein Convention?
   1. Yes
   2. No
5. Would you like to serve on a committee of the Missouri Holstein Association?
   1. Yes
   2. No
6. What suggestions do you have to improve your Missouri Holstein Association?

Click this button to calculate your registration fees and pay online.