The Large Black Hog Association | LBHA Membership Application

Thanks for your interest in becoming a member!

Please fill in the details below and select a payment type by scrolling to the bottom of this page. Your account will be created once your payment is received and verified. If you pay by Paypal this will be immediate! Paypal accepts check payments as well and you do not need to have an account with them to pay.

Membership Type*

Yearly Membership
Lifetime Membership

Total

$0.00

Name*

First Last

If you have multiple names, please fit them in the fields above.

Email*

Enter Email Confirm Email

Farm Name*

Please enter a name for your farm, business, hobby farm, etc. Use your name if you don't have anything else.

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

If you don't have a street address then please put your PO Box number in the Street Address field.

Phone*

Website

If you have a website you would like us to link to then please enter it here.

I Will be Selling Pork

I will sell pork

If you check this box then visitors to our site will be able to see quickly whether you sell pork or not.

Show in Membership List

Show My Details

If you check this box then your contact details will be shown in our membership list on the website. This is a great marketing tool. You can change this option at any time.

Preferred hog name prefix*

When you register hogs that were born on your farm they inherit their name from there. Example: hogs born on Joe's Farm can be named "Joe's Matilda 4/1 *0123", "Joe's Farm Matilda 4/1 *0123" or "JF Matilda 4/1 *0123". Please enter your preference for your hogs (limited to 15 characters). It may not be possible to use your preference.

Preferred Login Name*

This will be used, if possible, to log you into the LBHA website so that you can use the membership tools. Even if you don't want to use these features you will need an account so that your details will be on the membership list.

Password*

Enter Password Confirm Password

Strength indicator

The password you will use to login.

Comments

Total

$0.00

Payment Options*

Paypal (also accepts eCheck)
Check

Paypal is our preferred method of payment. You do not need to have a Paypal account to use this option. You can pay by check using Paypal as well.

To Pay by check please click on the button below. It will submit your details to the LBHA and you can then mail the check to the following address. Make sure your name and farm name are clearly marked on the check so that we know who is paying. Please send your check to:
LBHA c/o Noel Diesen 207 Little Fork Road, Cumberland City, Tennessee, 37050

APPLY FOR NEW LBHA MEMBERSHIP

Thanks for your interest in becoming a member!