North Dakota Beef Quality Assurance
Registration Form
Name:_________________________________________________________________
Operation Name:_________________________________________________________
Operation Brand:_________________________________________________________
Location & State Registered: ________________________________________________
Address:________________________________________________________________
City:________________________________State:_______________Zip:_____________
County:_________________________________________________________________
Telephone Number:________________________________________________________
E-mail address:___________________________________________________________
Signature:_______________________________________________________________
Would you like to be listed in a directory of producers in the North Dakota
Beef Quality
Assurance Program? Yes _____ No ______
On average how many cattle do you market annually? 0-50____ 51-150____
151-250 ____ 251-500 ____ 501-750 ____ 751-1000 ____ 1000 plus ____
Registration cost: $15.00
Please complete this form and send with your check made payable to: NDSU
Extension Service
Mail to:
Lisa Pederson, NDBQA Specialist
NDSU Extension Service
2718 Gateway Ave, #104
Bismarck, ND 58503
phone: 701-328-9718
lisa.pederson@ndsu.edu
NDBQA Certification Page
NDBQA Checklist Page
NDBQA Producer Manual
NDBQA Home Page