TAP Application

Name

Telephone Number

Address

Years as HTA member

Years working as a trimmer

Name of member for whom you are applying, if not yourself

Accident/Medical problem description:

Approximate recovery time:

Has medical treatment been sought?

Yes No

Please explain

What type of assistance is being requested?

Financial Trimming

Please Explain

How many head of cattle?

If trimming assistance is requested, how many days per week?

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