Application for Dairy Registration

Dairy Applicant

Date of Application
Member Number
Breeder/Applicant *
Farm Name or Prefix
Address
City
State
Zip Code
Phone Number
Email Address *

Information on Calf

Name
Birthdate
Calf ID
Sex
Percent Normande
Multiple Birth
Calving Ease
Horned/Pulled
Coat Color
Solid/Pattered
Eye Markings

Information on Parent

Sire Name *
Sire's Registration Number *
Sire's Birthdate *
Normande Percentage *
Grand - Sire
Name
Grand - Sire's Registration Number
Dam Name *
Dam's Registration Number *
Dam's Birthdate *
Normande Percentage *
Grand - Dam
Name
Grand - Dam's Registration Number

A.I Breeding

First Service Date
Bull Number
Second Service Date
Bull Number

Pasture Exposure

First Service Date to and From
Bull Number
Second Service Date to and From
Bull Number
Generic Consent *
By checking this box, you certify that all of the statements in this form are true and complete