Louisiana Mayhaw Association Application

Please print the application below. After filling in all applicable fields, enclose with a check to the Louisiana Mayhaw Association for $15.00 (US) and send to:

Louisiana Mayhaw Association, Inc.
P.O. Box 382
Jackson, LA 70748

Renewal fees are also $15.00 (US), and are due by April 1st of each year.
Application for Membership


Application Type: _____   New Member
_____   Renewal
Membership Type: _____   Producer
_____   Associate


Farm, Company, or Organization:   ____________________________________________________
Member Information:
Name:

 ______________________________________________________________
Address 1:

 ______________________________________________________________
Address 2:

 ______________________________________________________________
City:

 ______________________________________________________________
State/Province:

 ______________________________________________________________
Zip Code:

 ______________________________________________________________
Parish/County:

 ______________________________________________________________
Country:

 ______________________________________________________________
Email Address:

 ______________________________________________________________
Louisiana Mayhaw Association, Inc., P.O. Box 382, Jackson, LA 70748
Email: office@mayhaw.org
www.mayhaw.org