Cochins International Membership Application Form
Please print out this form and mail to the address below. 


Yes, I would like to join Cochins International.  Enclosed is a check made out to Cochins International.

Canadian members must send a Canadian Postal Money Order made out in US dollars only.  
(Single and Family Membership $15.00, Junior (under 18) $7.50)


Name _______________________________________________________________
(how it will appear on exhibitor lists)
 
Street or Box _________________________________________________________  

City, State, Zip _______________________________________________________  

E-mail Address:________________________________________________________

Cochins raised (include color and size) _____________________________________ 

____________________________________________________________________  

____________________________________________________________________

Do you ship birds, eggs or chicks? ________________________________________  


Send check to:   (made out to Cochins International)

Cochins International
attn:  Matt McCammon
RT #2 Box 98M
Bloomfield, IN  47424