APPLICATION MUST BE FULLY COMPLETED BEFORE ACCEPTANCE

Membership shall be limited to singles, age 18 and over, who are EMPLOYED IN AGRICULTURE, have a BACKGROUND IN AGRICULTURE, have an INTEREST IN AGRICULTURE, or are AFFILLIATED WITH ONE OF THE VARIOUS BRANCHES OF AGRICULTURE.   Applicants must be SINGLE, NOT MARRIED and NEVER CONVICTED OF A FELONY.

Name

Age

Sex
Male
Female

 

New Member
Renewal
If Renewal, current membership number:

Address
City
State   Zip
Phone
Email Address
   
Referred By

Agricultural Occupation or Background

Basic Membership (Name Only In Directory - No Resume) - $40.00
Resume Membership (Name, Address, and 50 word or less Resume in Directory) - $40.00
Coded Directory (First Name and Coded Number and 50 word or less Resume in Directory) - $40.00
Associate Membership (Singles No More - Names Only in Directory) - $40.00 Per Couple

Enter Resume Below
Include Birthday in Resume if you want it published. The first 50 words will be printed for your resume.

Chapter Affiliation - (Optional)
You may also choose to be a chapter member and receive chapter newsletters and other chapter benefits. Chapter membership is optional, however you must be a national member when joining a chapter. Chapters and their annual dues are listed below. Please choose which chapters you would like to join.

ILLINOIS - $12.00
KANSAS - $12.00
NORTHERN GREAT PLAINS - $15.00
ROCKY MOUNTAIN - $12.00
INDIANA - $ 12.00
MISSOURI - $12.00
OHIO - $12.00
TEXAS - $15.00
IOWA-WISCONSIN - $12.00
NEBRASKA - $12.00
OKLAHOMA - $15.00
 
Payment Method
I will mail a personal check
 

NATIONAL SIA annual dues $
CHAPTER (S)
annual dues $

TOTAL Amount Due
$

Your membership will not be active until payment is received.  Once your membership is paid, you will receive confirmation via postal mail

 Type your name here.  This will serve as your signature.

Signature 

Your membership may be terminated if any statements are untrue. (Application subject to review and approval)

 

Singles in Agriculture

SIA National Office
118 East Front Ave.
Stockton, IL 61085
Phone (815) 947-3559
sianationaloffice@singlesinag.org

 

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