Application Form

We hope that you will take advantage of all that the New York State Cheese Manufacturer's has to offer by becoming a member today! Simply print out this page, and complete the application ad return it with your check to: Janene Lucia, Assistant Treasurer, NY State Cheese Manufacturer's Association., 172 Stocking Hall, Ithaca NY 14853.

______________________________________________________________________________________________

I hereby apply for membership in the New York State Cheese Manufacturer's Association for the period of one year commencing _________________ (MM/YY) and agree to pay the membership dues applicable to my classification as indicated below:

ACTIVE VOTING MEMBER

_____ Manufacturer's of cheese shall pay a minimum dues of $300 and additional dues on the following schedule:

Additional $100 for each 1,000,000 pounds of cheese or fraction thereof in excess of one million pounds manufactured in the previous calendar year to a maximum total dues of $1,200
                                                                                                                $_________

_____ Supplier's of milk for the manufacture of cheese as follows:
Less than 500 million pounds of milk per year             $300.00
More than 500 million pounds of milk per year            $500.00

_____ Active members whose primary business is the assembly, processing cutting, packaging, and/or distribution of New York cheese and whose principal business location is within New York State shall pay annual dues of $300. Upon application to the board of directors, an out of state packager, processor, or distributor of New York State Cheese may be granted membership in this category.                                   $300.00

ASSOCIATE (NON-VOTING) MEMBERS

_____ Any other individual or firm interested in the activities and objectives of the Association.    $200.00

Dues shall be payable annually or semiannually in advance within thirty days after the beginning of any six month period. The subscription and membership continues from year to year unless revoked in writing by letter or other written notice to the President, Secretary, or Treasurer.

Date:____________________

Company Name: ____________________

Contact Person: ______________________________

Phone:____________________________                  

Address: ________________________________________
                  _________________________________________
                 __________________________________________

Please make your check payable to: NYS Cheese Mfrs. Assoc. and mail to: J.S. Lucia, Asst. treasurer, 172 Stocking Hall, Ithaca, NY 14853