NATIONAL SWINE REGISTRY
APPLICATION FOR MEMBERSHIP
Yes! I want to become a member of the National Swine Registry (please fill out every field):
NAME*
*If applying for a Senior Life Membership, you should indicate clearly the name in which the membership is to be recorded. If registrations are to be recorded in the name of a farm/ranch, the membership should be
in the name of the farm/ranch; if to be recorded in the name of a partnership, the membership should be in the name of the partnership, and at least two officers of a corporation must sign the application.
ADDRESS
CITY
STATE
PHONE #
EMAIL
HERDMARK Senior Life AND Junior Memberships
Please indicate three different choices you would prefer to use for
your herdmark*. The first available choice will assigned to you. *Due
to the number of 3-digit herdmarks in our system, please choose four letters for each of your choices.
BREED
Please indicate which breed(s). Check box(s)
Duroc
❒
Hampshire
ZIP
1st choice:
2nd choice:
3rd choice:
4th choice:
❒
Landrace
❒
Yorkshire
❒
PAYMENT INFORMATION
MEMBERSHIP LEVEL Check one
$85
Senior Life Membership*
*Fee of $85 covers the first year’s fees which includes
$10 for the Lifetime Membership plus $75 for first
year’s Maintenance Fee.
❒
Junior Membership
❒ $FREE
Birth Date**
ALL FIELDS ARE REQUIRED TO PROCESS CREDIT CARDS
❒ CHECK –
❒ CREDIT CARD ❒
Make checks payable to: NATIONAL SWINE REGISTRY
• SENIOR LIFE MEMBERSHIP: You are encouraged to join the individual breed
association if you are interested in breeding purebred Yorkshire, Hampshire,
Duroc or Landrace swine. A Senior member must be over 21 years of age
and a resident of the United States (or a corporation incorporated under
United States law). The Senior Life Membership fee is $10. This fee is paid
only one time and should accompany the application for membership.
• JUNIOR MEMBERSHIP: Activities for youth are a growing part of the National
Swine Registry program. To encourage junior activity, junior memberships are
available, at no charge, to all breeders under 21 years of age. Junior memberships
are issued only in the name of an individual person. Junior memberships
register and transfer under the same conditions as Senior Life Members.
• ACTIVE STATUS: To be an active Senior Life Member an annual maintenance
fee (annual dues) of $75 per breed is due and payable on Jan. 1, for
Yorkshire, Hampshire, Duroc and Landrace of each year. With this $75 annual
maintenance fee, the member will automatically receive a Seedstock EDGE
subscription. NOTE: “First Year” Senior Life Membership fees are $85; $10 for the lifetime membership
fee and $75 for the first year’s maintenance fee. After the first fiscal year, a maintenance fee of $75 per
breed is all that is required. The second criterion for active status membership is to
record breeding stock at least one litter during the previous fiscal year.
❒
Check one
Parent/Guardian Name**
**Junior Membership Only
• MAJOR CLASSES OF MEMBERSHIP: There are two types of National Swine
Registry membership: Senior Life Membership and Junior Membership. Within
each of these classes there shall be active and inactive status for members.
❒
NAME ON CARD
CARD #
3-DIGIT SECURITY CODE
(back of card)
EXP. DATE
TOTAL AMOUNT ENCLOSED
Mail form with payment to:
NATIONAL SWINE REGISTRY
2639 Yeager Road • West Lafayette, IN 47906
NATIONAL JUNIOR SWINE ASSOCIATION
APPLICATION FOR MEMBERSHIP
Becoming a member of the NJSA allows you the opportunity to travel and compete in shows across the country. The NJSA provides the
perfect chance to meet new friends that have the same interests as you - showing and raising purebred hogs! Another great reason to
join the NJSA is to improve your leadership skills while doing things you enjoy.
Yes! I want to become a member of the National Junior Swine Association
(please fill out every field):
NAME
ADDRESS
CITY
STATE
PHONE #
EMAIL
ZIP
BIRTH DATE
PARENT/GUARDIAN NAME
PARENT/GUARDIAN PHONE #
Mail form to:
NATIONAL SWINE REGISTRY
2639 Yeager Road • West Lafayette, IN 47906
SCHOLARSHIPS
All scholarship information and applications can be found on the
NJSA page at www.nationalswine.com/njsa.
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Claude Robinson Scholarship ($1,000)
Jason Shipley Scholarship ($1,000)
Gregory D. Johnson Scholarship ($1,000)
The Maschhoff’s Inc. Pork Production Scholarship
(up to 5 worth $1,000 each)
NJSA Visionary Leader Scholarship ($500)
NJSA Outstanding Member Scholarships
> Two Senior Scholarships (ages 17-21): $1,000
> Intermediate Scholarship (ages 13-16): $500
> Junior Scholarship (ages 9-12): $300
> Novice Scholarship (ages 8 & below): $200
Juniors helping Juniors Scholarship ($1,000)
American Yorkshire Club Scholarship ($1,000)
TC Trailer Sales Scholarship ($500)