W.O.W. MEMBERSHIP FORM


W.O.W. MEMBERSHIP STATUS (PLEASE CHECK ONE)
____ I wish to become a Full member of W.O.W. or renew my membership ($50.00).  A Full member is a
licensed Wisconsin cervid farmer.
License Number: __________________
____ I wish to become an Associate member of W.O.W. or renew my membership ($25.00).  
An Associate is a spouse/family member/partner of a licensed Wisconsin cervid farmer, or anyone else
interested in the business.
____ I have already renewed my W.O.W. membership as Full/Associate (please circle one).  (Dues paid after
January 1.)
____ I would like to become a lifetime member of W.O.W. ($500.00)

W.O.W. MEMBERSHIP DIRECTORY AND INTERNET DIRECTORY (PLEASE CIRCLE YES OR NO).  
Would you like to be listed in the membership directory?  YES / NO
Would you like to be listed in the Internet directory on W.O.W.’s website?  YES / NO

If you answered yes to either of the above questions, please provide the following information:

Farm/Business Name:
______________________________________________________________________________________

Name & Address:
__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

Phone #:  ___________________________ Cell #:  ____________________________ Fax #:  
____________________________

E-mail address:  
___________________________________________________________________________________________
_

Website address:        http://  
______________________________________________________________________________________

PLEASE CIRCLE ALL THAT APPLY FOR THE FOLLOWING.  

What animals do you raise and/or sell?     Whitetail     Elk     Red     Fallow     Sika     Reindeer     Other
_______________

What do you sell?     Breeder Bucks/Bulls/Stags     Shooter Bucks/Bulls/Stags     Adult Does/Cows/Hinds     
Bred Does/Cows/Hinds
     Buck Fawns     Doe Fawns     Bottle-Fed Fawns     Hunts     Nothing at this time

Describe antler characteristics:        ____% Typical     ____% Non-Typical

Specialty products or services:  
_______________________________________________________________________________

Other animals or products:     White Whitetails     Piebald Whitetails    Venison     Antlers     Semen     Urine   
Feed/Minerals
If other, describe:
__________________________________________________________________________________________

Testing status:     TB accredited     TB qualified     Brucellosis certified     Brucellosis qualified     CWD
monitored since ________

Brief description:  Please provide information pertaining to your operation, such as number of animals,
acreage, years of operation, or more about your products/services, etc.  Please provide the information the
exact way you want it in the directory and/or website.
___________________________________________________________________________________________
______________
___________________________________________________________________________________________
______________
___________________________________________________________________________________________
______________
___________________________________________________________________________________________
______________
Please check one: For the directory, I want to use ___the same picture as last year,   ___a new picture
(attached),  ___no picture.

NOTE:  You may include one picture to be posted next to your farm/business information on the website and
in the membership directory.  Pictures will not be returned.  THIS FORM MUST BE RETURNED EACH YEAR
BY THE DATE OF THE ANNUAL MEETING IF YOU WOULD LIKE YOUR FARM OR BUSINESS TO BE
INCLUDED IN THE DIRECTORY.  Thank you!

Make checks payable to W.O.W.              Send your dues with this form to: Myndi Margan
                                                     2533 Southerland Circle
                                                   Kaukauna, WI  54130