Membership Application

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Membership Application and Milk Check Assignment

Dairy Pricing Association, Inc.

The patron listed below requests that 10 cents per CWT per two week or once a month  pay period be forwarded to Dairy Pricing Association Inc. (DPA). Dairy Pricing Association will contact the dairy plant with instructions for depositing funds.

Patron Name                                                                               Patron Number
City                                                                 State                      Zip
Phone                                                              Email Address
Patron Signature                                            Date                      If organic, check here:


Dairy Plant/Marketer Name:
City                                                                 State                    Zip

My signature on this form authorizes the above listed handler to relay information on the processing plant where my milk is being delivered. DPA may request this information at any time to purchase product from the processor.

Under Dairy Pricing Association (DPA) bylaws your 10 cents per cwt contribution is considered your membership dues. The dues cannot be raised without a majority vote of the membership. The producer can terminate this check off at any time.

This agreement gives DPA permission to use your money to purchase dairy products from plants other than the one you are shipping to in the event they do not have the needed product, the price is too high, or  location of their product makes transportation a problem.

Note: If there is a humanitarian relief organization in your area that you would like DPA to donate to, please give us contact information.

Application may be mailed or faxed to:

DPA, Inc.
W15311 Franklin Road
Taylor, WI  54659

Fax: (715) 284-2591
Phone: (715) 284-2590

The DPA is a 501C5, which is a not for profit organization. Your accountant/tax preparer can advise you as to the tax status of your donation.

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