119 W. Sherman, Hutchinson, KS 67501 - Ph: 620-664-6297 - Cell Ph: 620-200-1381 - Fax: 620-664-6265

MEMBERSHIP APPLICATION

To join U.S.C.H.I., or renew your membership, please complete the form below. If paying by check, send payment to:

U.S. Custom Harvesters, Inc.
119 W. Sherman
Hutchinson, KS 67501

** Annual dues run from Jan 1st - Dec 31st with the exception of the Lifetime Membership. You will receive a free subscription to the monthly magazine Harvest News; Free classified ads in the Harvest News for harvester members; Free membership directory; Invitation to the annual convention; Free safety handbooks and videos; Included in all lobbying efforts; Built in networks and relationships with other people involved in the industry.

** Associate members can advertise in our newsletter

Contact Information
*Company or Business Name
*Type of Business
*Member Name
*Street Address
*City
*State
*Zip
*Telephone
Cellphone
Cellphone 2
*Email Address
Fax
Website
No. of Combines
Brand
No. of Choppers
Brand
No. of Trucks
Brand
Years of Experience
Membership Options
Check if you want your cell phone published in the directory.
Check if you want your information available on the website.
Check if you would be interested in serving on a committee. (Safety, Scholarship, Legislative).
Check if you would be interested in running for the Board of Directors.
"Harvest News" shipped First Class ($24.00)

Harvester Membership ($200.00)
Associate Membership ($150.00)
Non-U.S. Harvester Membership ($250.00)
Lifetime Membership ($1,750.00)
Referred By