ICA Membership Application Member Number Contact Name* Ranch/Business Name* Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code County* Phone*Email* General Member Benefits: New members receive a 12"x18" aluminum "No Trespassing" gate sign ICA membership card ICA member decal ICA bumper sticker Subscription to the Southern Livestock Standard ($20 value) Networking opportunities Local chapter meetings Timely updates on legislative and industry information. Many of these updates come instantly via EMAIL. Membership Levels:Wrangler Price: $100.00 Quantity: Includes general member benefitsRancher/Family Price: $125.00 Quantity: Includes general member benefits, gate signRancher/Family: Please indicate if you would like the gate sign Yes No Round Up Price: $150.00 Quantity: Includes general member benefits, gate sign, capRound Up: Please indicate if you would like the gate sign Yes No Cattle Boss Price: $250.00 Quantity: Includes general member benefits, gate sign, cap, special ICA giftCattle Boss: Please indicate if you would like the gate sign Yes No Extra Hand Price: $500.00 Quantity: Includes general member benefits, gate sign, cap, special ICA giftExtra Hand: Please indicate if you would like the gate sign Yes No Top Hand Price: $1,000.00 Quantity: Includes general member benefits, gate sign, cap, special ICA giftTop Hand: Please indicate if you would like the gate sign Yes No Junior/Collegiate Price: $20.00 Quantity: Includes general member benefits, t-shirtJunior/Collegiate - Select T-Shirt Size Small Medium Large XL Optional: Donation to ICA scholarship fund in memoriam of Steffany Lynn Sklar (does not go toward dues) Votes: ICA "Wrangler" members are allowed one delegate vote. All other membership levels will be eligible for two votes with the exception of Junior/Collegiate members, which will not have voting rightsTotal $0.00 Payment Method* I will call the ICA office at 512-620-0162 with my credit card info. I will mail a check for the above total to the ICA Office at PO Box 1168, Lockhart, TX 78644 I will provide my credit card details here so ICA can process the charges. Please provide your credit card details here. Please include:Type of card: (Visa, MasterCard)* Name of Cardholder:* Card Number:* Expiration Date:* ID number on back of card:* Dues to Independent Cattlemen’s Association are not deductible as a charitable contribution but may be deductible as an ordinary and necessary business expense. The nondeductible portion of dues is 15%.NameThis field is for validation purposes and should be left unchanged.