Directory Information
                    Directory Type (*) 
                        
                             
                            
                      
                    
                      
                              
                    Name of Operation (*) 
                    
                    
  
                     Name of Owners/Operaters (*) 
                    
                    
  
                    Prefix Name 
                    
                    
  
                     AJCA Customer Number 
                    
                    
  
                     Address (*) 
                    
                    
  
                    Address 2 
                    
                    
  
                     City(*) 
                    
                     
                     
                    State/Province(*) 
                    
                     
                     
                             Postal Code (*) 
                                       
                    
  
                     Country (*) 
                
  
                    Email Address (*) 
                    
                     
  
                    Phone Number (*) 
                                       
                    
  
                    Alt. Phone Number 
                                       
                    
  
                    Fax Number 
                                       
                    
   
                     Additional Contacts   
                            
                                Enter any additional contacts that you would like to include in the directory. Enter one person per line. You can include items such as their name, phone, email, etc...
                                 
                                
                             
                            
       
                    Website Address 
                                       
                    
  
                    
                                 
  
                            Directions to farm (*)
                             
                                       
                              
                              
                    AJCA Programs (select the items that apply)
                            
                                
                                 
                                
                                 
                                
                                 
                                
                                 
                                
                            
                    
  
                            Number of Milking Cows 
                                               
                    Directory Options
                             Additional Directory Options 
                             
                             
                             
                              
                    
                             
                              
                              
                             Expanded Message ($1 per word)  (Enter your expanded message below and click "Include Message") 
                             
                              
                             Include Message
                              
                              
                            
  
                    
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