KENTUCKY NUT GROWERS ASSOCIATION Douglas Hines 679 Townsend Valley Road Paris, KY 40361

FIRST CLASS

TO: Douglas Hines 679 Townsend Valley Road Paris, KY 40361

☐ NEW MEMBER ☐ RENEWAL

DATE ___

□ CHANGE OF ADDRESS

NAME ___

ST OR RFD ___

CITY ___ STATE ___ ZIP ___

EMAIL ADDRESS ___

OCCUPATION _____ COUNTY _____

AMT. ENCLOSED FOR DUES $_____ FOR YEAR(S) _____

Dues are 5.00 for one year. Annual membership begins January 1st. New members joining after July 1st shall be credited as paid in full for the next calendar year.) For additional information about joining KNGA, please contact Ken LaVere, 270-369-8764.