MEMBERSHIP APPLICATION

Annual Membership Dues - $20.00


Date:

 Name:

 Address:

 City:

State:

Zip:

 Telephone:

Fax:

E-Mail:

 Crops grown:

Acres:

 Signature:
Return completed application with check to

MFVGA
P.O. Box 231
Crystal Springs, Mississippi 39059

Information:
Telephone: 601-892-3731 - Fax: 601-892-2056
EMail: wbe@ra.msstate.edu