Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Sex of Animal *

Male

Female

Skull Type: *

Polled

Horned

Scurred

Animal Date of Birth: *

MM

DD

YYYY

Multiple Birth? *

Yes

No

Weaning Date

MM

DD

YYYY

Date of Yearling Weight:

MM

DD

YYYY

Agreement to Terms *

I Certify that the information on this form is correct and that the animal is eligible for registration in the herd book according to the rules and By-Laws of the American Beefalo Association.

I agree

I do not agree

Signature *

Please type your name certifying you agree to the application terms and conditions.

First Name

Last Name