Membership Application


For a printable registration form :: click here

Date: ____________________________

Name:____________________________(check one) Male Female

Date of Birth:_____________________

Address:______________________________ 

City:________________________

State:_________________________ 

Zip: _________________________

Phone Number: (____)____-______  

Email Address:________________________

Parent or Guardian:___________________________________________________

Local Newspaper Name:______________________________________________

Newspaper
Address:__________________________________________________


Paid:_____
    Check Number:________

Notify using (check one):   Email    Postal Mail System

Email Address: ____________________________________________

Showmanship Age As of January 1st
Jr. (8-11)
Int. (12-15) Sr. (16-21)

Send Registration Form to:
Junior Nebraska Cattlemen
Kelsey Stubbendick

1472 N. 28th Road
Avoca, NE 68307