Become a Member

Application for Membership

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Application is hereby made for membership in the National Association of Animal Breeders, Inc. to be issued in the name of

If approved,

Election users

agree to be bound by and abide by the provisions of the Association's Bylaws and policies adopted by its Board of Directors, so long as the applicant is a member of the Association. Applicant hereby certifies that the applicant has received a copy of the Bylaws of the Association and all principal officers and managers of the company have been instructed by the applicant to familiarize themselves with the contents of said Bylaws.

Applicant further agrees to hold the National Association of Animal Breeders, Inc., its Board of Directors, officers, agents, servants and its employees harmless for any damages that may accrue to the applicant, its officers, agents, servants and employees as a result of membership in the Association.

Type of Membership Applied For:

A remittance is enclosed for payment of membership application fee. The undersigned applicant (if an applicant for Regular membership) further expressly agrees to file a complete report of semen production and sales in the format that is uniform for all members, and submit payment of dues to the Association in the amount and at the time which may be specified by the Bylaws of the Association and any amendments thereto.

If the applicant applies for Regular membership, the applicant further agrees to enter into an agreement for Semen Identification and Sire Health Auditing with Certified Semen Services, Inc. (CSS) if so required by the Bylaws of the Association or any amendments thereto.

The undersigned, if an applicant for Regular membership, understands that the undersigned is entitled, while a Regular member in good standing of the National Association of Animal Breeders, Inc., to utilize the Association's logo and to publicize the fact that the undersigned applicant is a Regular member of the National Association of Animal Breeders, Inc. If, however, at any time the undersigned Regular membership is terminated for any reason, the applicant, if a Regular member, agrees to cease and desist from any further use of the logo of the National Association of Animal Breeders, Inc. and to further desist from any use, reference, or claim of membership in the Association from and after the time of final termination.

The undersigned, if an applicant for Associate membership, understands the undersigned is entitled, while an Associate member in good standing of the National Association of Animal Breeders, to utilize the association's logo with the word "Associate" listed there under. The undersigned understands that it is not proper to utilize the NAAB logo without the word "Associate" beneath it. It is further agreed that subsidiaries of NAAB Associate members are not entitled to use the Association's logo. Any subsidiary of an associate member must apply for Associate membership in the same manner as other applicants. The undersigned further agrees that, if at any time, the Associate member of the undersigned is terminated for any reason, the applicant, if an Associate member, agrees to cease and desist from any further use of the logo of the National Association of Animal Breeders, Inc. And, further desists from any use, reference, or claim of membership in the association, or to advertise in any way that such person is still a member of the Association after the time of receipt of notice of final termination.

Applicant agrees to file a completed report of Supplemental Information, a copy of which is attached hereto and incorporated by reference as a part of this application form. The National Association of Animal Breeders, Inc. is hereby authorized to obtain a credit report on the applicant or on the chief executive officer if the applicant is a company.

The undersigned person hereby certifies that he is authorized to execute this application for membership on behalf of the applicant.

* Expiry Date of Credit Card (MM/YY):

Signature (please sign on the line box):

SUPPLEMENTAL Information for MEMBERSHIP

Note: The following information is submitted to supplement applicant's application for membership in the National Association of Animal Breeders (NAAB) and is incorporated by reference as a part of said application.

I. NAMES AND ADDRESSES OF OWNER(S):

** Regular member applications must include an electronic copy of a "Certificate of Good Standing" from the Secretary of State of the applicant's state of organization.

II. TYPE OF ORGANIZATION:

Type of Organization

III. BUSINESS ACTIVITY:

A. Semen Production and Sale

3. Number of units of semen sold and marketed through insemination service and direct semen sales during your last fiscal year:

6. Number of units of semen purchased during your last fiscal year:

B. Custom Freezing

1. Number of units of semen custom frozen during your last completed fiscal year:

C. Date business activity initiated

This information is for administration purposes. Reporting is to remain consistent for each calendar year. Changes should be communicated to NAAB Administration before the end of the calendar year.

IV. ADMINISTRATIVE AND MANAGEMENT PERSONNEL:

V. OFFICERS AND DIRECTORS (List names and addresses):

VI. SUITS OR JUDGMENTS:

* A. Have any suits or judgments been filed against applicant?

VII. CRIMINAL CONVICTIONS:

* A. Has applicant or any of its principal officers been convicted of a felony?

VIII. REFERENCES:

A. Business References

B. List two or more persons affiliated with NAAB REGULAR MEMBER ORGANIZATIONS familiar with your operation as references. Please obtain approval from all persons listed. List name and address of each AI organization.

Note: Certificate of Good Standing must be submitted for the application to be processed.