| To become a member of the Champaign County Cattlemens Association, fill in and mail form along with cash, check, or money order made out to Champaign Cattlemens Association. Membership dues are $10.00 per year. |
| Name __________________________ Address ________________________ City ______________ State _____ Zip _________ Phone ______________ Cell _________________ Please send check, money order or cash to: Richard Sour 214 Lafayette Ave. Urbana, OH 43078 Make checks and money orders payable to: Champaign Cattlemens Association. |
| Cattlemen's Membership Form |

| Champaign County Cattlemen's Association Urbana, Ohio |