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ADDRESS: __________________________________________________________

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TELEPHONE: ________________________________________________________

EMAIL: ____________________________________________________

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BREEDS or Varieties Raised:__________________________________________

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WOULD YOU LIKE TO BE LISTED IN THE ONLINE DIRECTORY? ___YES ____NO

INDIVIDUAL - $7.50 FAMILY - $10.00

Please print and fill out:

Mail to:

Agnes Wilson
HPFA Membership
P.O. BOX 70
MALIN, OR. 97632