A $10.00 check made payable to Heart of America Game Breeders’ Assn. or HOAGBA must be sent with this application to Terry Smith, 14000 W. 215th St.,

Bucyrus, KS 66013-9519. If there isn’t enough space provided below for listing the species you raise, feel free to write them on a sheet of paper and attach it to the application.

 

Name;_________________________________________________________

 

Farm Name:____________________________________________________

 

Address:_______________________________________________________

 

City’______________________  State:___________ Zip: ________________

 

Phone _____________________ Application date:______________________

 

E-mail Address:________________________________________________

 

 

Species You Raise

 

Pheasants:

 

 

 

Peafowl:

 

 

 

Quail, Partridge, Grouse, Francolins

 

 

 

Wild Waterfowl:

 

 

 

Aviary Birds:

 

 

Domestic Poultry & Waterfowl:

 

 

Miscellaneous: 

 

 

 

Signature:_______________________________ Date:________________

HOAGBA Bird & Animal Auction Gardner, KS

HOAGBA Membership Application