ASAA Application

AMERICAN SOCIETY OF AGRICULTURAL APPRAISERS
1126 Eastland Dr. N., Suite 100
P.O. BOX 186
TWIN FALLS,
IDAHO 83303
(208) 733-2323
Fax (208) 733-2326 E-Mail: ag@amagappraisers.com

MEMBERSHIP APPLICATION

You can download the application in PDF format Here

If you do not have Adobe Acrobat you can download it free Here

Please write plainly or print. This application becomes a permanent record if you are accepted as a member.

It is the policy of The American Society of Agricultural Appraisers to recruit qualified personnel without discrimination because of Race, Color, Religion, Age, Sex, National Origin, or handicapped condition and to give no preferential treatment to any applicant.

Name (Last)________________________

(First)________________________

(Middle)_______

Home Address (Street)___________________________________

(City) __________________________________

(State)___________

(Zip Code) _____________________________

Home Telephone (

) _________________________________

Cell Telephone (

) _________________________________

Business Telephone (

) _________________________________

Fax Number:___________________________

Email Address: __________________________________________

Mailing Address ________________________________________

(City) __________________________________

(State)___________

(Zip Code) _____________________________

Do you have a valid driver's license?

Yes

Number_______________________________

State ________________________

Date of Birth __________________________

Expiration Date (Year)__________________

Do you have any relatives associated with this society? Yes

STATEMENT OF HEALTH
Do you have any physical condition which may limit your ability to perform an appraisal? Yes

If yes, explain
___________________________________________________________________________________________

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PERSONAL
Have you ever been expelled from or given an official reprimand by a professional organization or been convicted of a
felony related to business practices or ethics?
If yes, please elaborate. (Enclose a separate statement if necessary.)Yes

___________________________________________________________________________________________

___________________________________________________________________________________________

If you have been convicted of a felony, the nature of the felony and the length of time since conviction will be important
considerations. If you have been convicted of a felony, you will not be automatically disqualified, and you will be given
the opportunity to explain any convictions that adversely affect membership.

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List professional organizations, special interests, or hobbies.

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EDUCATIONAL DATA

School Attended	Name	City	State	Circle Last Grade Completed	Major	Degree
High School				9 10 11 12
Community College				1 2
College or University				1 2 3 4 5 6 7 8
Trade School/ Apprenticship School				1 2 3 4

EMPLOYMENT RECORD --- List employment for the last 10 years, beginning with last or present job.

Company Name:
Street Address:
City & State & Zip:
Telephone:
Job Title:
Supervision:
Dates Employed:	Mo/Yr__________________________ To Mo/Yr__________________________
Reason For Leaving:

Company Name:
Street Address:
City & State & Zip:
Telephone:
Job Title:
Supervision:
Dates Employed:	Mo/Yr__________________________ To Mo/Yr__________________________
Reason For Leaving:

Company Name:
Street Address:
City & State & Zip:
Telephone:
Job Title:
Supervision:
Dates Employed:	Mo/Yr__________________________ To Mo/Yr__________________________
Reason For Leaving:

SELF EMPLOYMENT: IF SELF - EMPLOYED OR IF YOUR FARM EXPERIENCE INCLUDES SELF-EMPLOYMENT,
IT IS VERY IMPORTANT TO INCLUDE A BRIEF EXPLANATION FOR THE PAST 10 YEARS.

Please place on a separate piece of paper if necessary.

___________________________________________________________________________________________

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PERSONAL REFERENCES - (Give four references, not relatives, who can vouch for your ethics, credibility and
competence. It is important to type or print clearly, and be sure to include complete addresses, including zip code
and fax number if available.)

Name:
Street Address:
City & State & Zip:
Telephone:
Fax:

Name:
Street Address:
City & State & Zip:
Telephone:
Fax:

Name:
Street Address:
City & State & Zip:
Telephone:
Fax:

Name:
Street Address:
City & State & Zip:
Telephone:
Fax:

IF YOU ARE APPLYING FOR BOTH LIVESTOCK AND FARM EQUIPMENT DESIGNATIONS, PLEASE FILL IN BOTH LIVESTOCK AND FARM EQUIPMENT SECTIONS.

LIVESTOCK APPLICANTS --- (INTERNATIONAL SOCIETY of LIVESTOCK APPRAISERS)
List the particular breeds of livestock you are familiar with:

1. _____________________________________________

2. _____________________________________________

3. _____________________________________________

4. _____________________________________________

5. _____________________________________________

6. _____________________________________________

7. _____________________________________________

8. _____________________________________________

FARM EQUIPMENT APPLICANTS --- (AMERICAN SOCIETY of FARM EQUIPMENT APPRAISERS)
List Brand Names of farm equipment you have worked with or are familiar with, including any specialized equipment.

1. _____________________________________________

2. _____________________________________________

3. _____________________________________________

4. _____________________________________________

5. _____________________________________________

6. _____________________________________________

7. _____________________________________________

8. _____________________________________________

a. Row Crop:

b. Hay Equipment:

c. Light Construction:

d. Heavy Equipment:

e. Truck and Trailer:

Are you willing to travel? _____________ If yes, how far? _____________________

How many hours per week could you work?_________________

Do you have any other business interests that could compliment membership in this society? If so, explain:

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PLEASE READ BEFORE SIGNING. If you have any questions regarding the following statement, please ask them of a society representative before signing.

I authorize my previous employers, (Please contact the Association Headquarters if you do not want to have your current employer contacted.) schools or persons named as references to give any information regarding my employment or educational record. I agree that my previous employers shall not be held liable in any respect if a membership is not tendered, is withdrawn or my membership is terminated because of falsity of statements, answers or omissions made by me in this questionnaire. In the event of my membership with the American Society of Agricultural Appraisers, I will comply with all of the rules and regulations as set forth in, or other communications distributed to all members.

I certify that all statements made by me on this application are true and complete to the best of my knowledge and that I have withheld nothing that would, if disclosed, affect this application unfavorably.

I hereby acknowledge that I have read the above statement, that I understand the same; and that I agree to abide by them.

Signature _____________________________________________

Date___________________________________

MEMBERSHIP FEE SCHEDULE: (Give four references, not relatives, who can vouch for your ethics, credibility and competence. It is important to type or print clearly, and be sure to include complete addresses, including zip code and fax number if available.)

American Society of Farm Equipment Appraisers
$145.00	Processing Fee - Must accompany completed membership application.
$250.00	Remaining Certification Fee - Must be mailed when notified of acceptance into the Association, along with signed Code of Ethics.
$395.00	Total Fee

International Society of Livestock Appraisers
$145.00	Processing Fee - Must accompany completed membership application.
$250.00	Remaining Certification Fee - Must be mailed when notified of acceptance into Association, along with signed Code of Ethics.
$395.00	Total Fee

Dual Membership - American Society of Farm Equipment Appraisers and International Society of Livestock Appraisers
$180.00	Processing Fee - Must accompany completed membership application.
$315.00	Remaining Certification Fee - Must be mailed when notified of acceptance into Association, along with signed Code of Ethics.
$495.00	Total Fee

Note: In all cases, if your application for membership is denied, your processing fee will be completely refunded. Semi-annual dues are $55.00 per member (becomes due six [6] months after certification). If you have any questions regarding the above membership fees, please call the Association office. Membership fees for the American Society of Agricultural Appraisers are deductible as ordinary and necessary business expenses. SEC 6113 IRS. CODE

Please return this portion with your payment:

My check or money order enclosed

Please charge $ _____________________ to my

Name On Card___________________________________

Card #___________________________________

Exp. Date ___________________________________

Daytime Phone ___________________________________