Annual Fee: $25.00. Please submit check payable to:
CMdPPG
c/o Steve Weber
2526 Proctor Lane
Baltimore, MD 21234
NAME:________________________________________________________
FARM NAME:__________________________________________________
EMAIL: _______________________WEBSITE________________________
ADDRESS:_____________________________________________________
TOWN:_______________________ ST: _________ ZIP:_________________
To become a member of CMdPPG, I agree to:
- Complete the MD Dept of Agriculture's Poultry Processing License Training and receive a license from the State of MD.
- Abide by the processing schedules established at the processing facility.
- Pay all my fees for chicks at the time of pick-up.
Please estimate the type and quantity of poultry you expect to process in 2012.
(include estimated quantities for all that apply.)
- __________ Whole Chickens
- __________ Whole Turkeys
- __________ Whole Geese
- __________ Whole Ducks'
- __________ Chickens Cut-Up
- __________ Other: _______________________ (please provide description)
- __________ Other: _______________________ (please provide description)
| YES | NO | Please answer questions below | | ___ | ___ | Are you interested in marketing a portion of your production jointly with CMdPPG? | | ___ | ___ | Are you interested in group purchasing chicks? | | | If yes, please estimate Qty:________ & How Often: ____________ | | ___ | ___ | Are you interested in group purchasing feed? | | | If yes, please estimate annual usage: _____________(tons) |
SIGNATURE: ______________________________ DATE:_____________________
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