ME ASSOCATION OF LIVESTOCK EXHIBITORS~ MEMBERSHIP APPLICATION JULY 1, 2015 ~ JUNE 30, 2016 Please print. Please fill out completely. Incomplete information or illegible writing may cause delays. ~ This form is NOT proof of membership. ~ Form invalid after 6/30/16 ~ Name First Name MI Last Name Birth Date First name Last Name Birth Date First Name Last Name Birth Date First name Last Name Birth Date First name Last Name Birth Date Primary Member Age 18 or older Spouse Children Under age 18 Dependents 18 and over MUST have own membership Additional children listed on the back. Mailing Address Street: All mail sent to Primary member Town: State: Phone Home: Cell: ZIP: Email: Farm Name Animals Exhibited i.e. Beef, Dairy, Show Steers, Sheep, Swine, Equine, Poultry etc. Please list all commodities exhibited. New Family $40.00 Includes Head of Household, Spouse Membership Type Requested and/or Children under age 18 . Renewal Individual $25.00 Single person 18 years of age or over. Includes dependents age 18 and over. RETURN CHECK FEE IS $35.00 www.mainelivestockexhibitors.org to join online Date Application Received: For BOARD MEMBER use only Card Sent via: USPS emailed hand delivered Amount Paid: Valid only when signed by MALE BOARD MEMBR Check # DATE: Cash DATE of signature: TIME: AM We do not accept memberships under a business name. Check payable to: MAINE ASSOCIATION OF LIVESTOCK EXHIBITORS (MALE) And mail to: M.A.L.E. C/O Amanda Wacome 97 Canaan Road Clinton, ME 04927 melivestockexhibitors@gmail.com FOR MORE INFORMATION ON MEMEBERSHIP ONLY PLEASE CALL 207-399-3255 For fair/exhibiting related questions call appropriate fair official www.mainefairs.org. PM