MEMBERSHIP and STUD NAME
APPLICATION

Membership runs from 1st January – 31st December annually.Please fill out the following information and allow up to 7 days for processing.

Please note that this form will not be submitted unless ALL fields are filled in. You must put N/A if it is not applicable to your application.

APPLICANTS DETAILS
Name of Applicant/s:  
Applicant 1:
Applicant 2: N/A if not applicable
If Junior member DOB: N/A if not applicable

Postal Address:Your postal address will not be listed for public access

Street Address:Your Street address will not be listed for public access


 N/A if not applicable
Email: N/A if not applicable
Pic Number:
Website:
Home Phone :
Mob: N/A if not applicable
MEMBERSHIP APPLICATION
FULL MEMBERSHIP
   
PRO-RATA (new members only if joining after 1st August)
   
ANNUAL RENEWAL
   
SOCIAL MEMBERSHIP
   
I would like to receive my newsletter
   
If membership renewals are not received by the 31st January, an application for new membership will be required. This will incur and additional $10.00 joining fee.

STUD PREFIX APPLICATION If you intend to become a breeder you will need a stud name to register your stock. This is a life-time registration. You must be a member or applying to be a member to be eligible.

Your Stud Prefix will precede the names of the animal’s you register. When applying for a stud prefix, please submit two (2) different names in order of preference - we will make every effort to allocate you with your first choice unless that name has already been registered.

I would like to Register a STUD NAME

1st Choice PREFIX: N/A if not applicable
2nd Choice PREFIX: N/A if not applicable
PIC Number: Please see notes below, you must allocate a PIC No.
Property Identification Code, issued by your local DPI, to Owners of Livestock.

*To be eligible to register a stud name a PIC (Property Identification Code) assigned to you by your local DPI is required prior to any application being considered.
Please Note:- You will be notified if your stud name has been accepted with your membership welcome letter. 
Your chosen name is not automatic and will be checked with the MGBA Stud Listing to ensure that names are not the same or too much like another established stud.  It is a good idea to submit two names.

I / weunderstand by submitting this application that I am signing to apply to become a Member / Renew Membership or applying for a Stud name with the Miniature Goat Breeders Association of Australia Inc. (MGBA) I / we understand and agree that if this application is accepted, I / we will be bound by the rules, regulations and Code of Ethics set by the MGBA. and any decisions, actions and amendments of the MGBA.

I / we authorise the MGBA. & those associated with them, to list and pass on my/our details, (Name, stud name, phone number, suburb/area, state, postcode, email, website) to enquirers and to include them in publications, handouts, website and other promotional material.

MGBA membership may include one single person, family members of the same household or two adults under the same stud name (Joint membership). A parent/guardian must sign for junior members. All adults 18yrs and over, including parent/guardian must complete the Signing Authority below.
Must be 18 yrs or over to accept.
JUNIOR APPLICANTS Parent/Guardian must accept
Parent/Guardian Name:
Phone:
PAYMENT DETAILS

Fees have been Paid by

Please make cheque/money order payable to the: Miniature Goat Breeders Association of Australia Inc. OR
I have paid by Direct Deposit to Miniature Goat Breeders Association of Australia Inc.
( ANZ Bank), BSB: 014509  Account: 485194316 Please use your Stud name or Surname as reference.