CAPA Membership

 

Membership is free and open to all and contributions are greatly appreciated.

 

 Personal Name                     _____________________________________

Organization Name               _____________________________________

Street Address                      _____________________________________

Mail Address                         _____________________________________

City, State, Zip                       _____________________________________

Phone                                     _____________________________________

Email                                      _____________________________________

 

To assist us in speaking with elected officials feel free to fill out the information below:

Are you an agricultural producer?      Y      N

How many acres do you operate on? ______

Are you a business ?      Y      N

How many customers do you serve on an annual basis ?________

Are you a home owner? _______

 

 

Mail to:

 

CAPA

P.O. Box 461

Yuma, CO 80759