Farm Name Registration


Date:
________________
                                Registration Fee: $50.00

Please Register the following Farm Name:

________________________________________________

Registered names are listed in the Spring issue of the Percheron News each year. Please check this list.

New names are published in each issue.


This registered name is owned by:______________________________________________________


Address:__________________________________________________

Phone:_____________________________________

City:______________________  State:_____________ Zip:__________
 

Please list the names of all persons that are allowed to use this name:

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

Signed: _________________________________
 
 

Complete form and return to the Association with a fee of $50.00

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