Print this form and return to TJBA, P.O. Box 1298, Liberty, Texas 77575

Application is hereby made for membership in the Texas Junior Brahman Association to be issued in the name of:

__________________________________________________________

If elected, I agree to be governed by the rules, regulations, constitution and by-laws of the Association as amended from time to time. The fee of $20 is enclosed, and it is understood that the membership will remain in effect up to and including the year of high school graduation and not older than nineteen. I understand that I will need to pay the $5.00 annual activity fee each year, beginning next year, to remain active.

Date of birth: ___________________________________

Address: ______________________________________

City, State, Zip _________________________________

Phone: _______________________________________

School classification: _____________________________

Signature of applicant: ____________________________