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2014 WFDA
RENEW & NEW MEMBERSHIP FORM Date: __________________________________ Member
Name ____________________________________________________ DOB _______________ Phone
# _____________________________________ Cell ___________________________________ Email_______________________________________________________________________________ Address
___________________________________________________City ________________________ State/Prov___________________________Country_______________________Zip
________________ Member
Spouse Name____________________________________________
DOB ______________ Additional
Family Names ____________________________________________ DOB ______________ __________________________________________________________________ AREA___________
*** Insurance Premiums apply to US and Canada Only! *** New Membership – initiation Fee - (Patch, Pin) Membership Fee $45.00 Insurance
$15.00 Initiation
$10.00 Total $70.00 _________ Additional Member $20.00 Insurance $10.00 Initiation
$10.00 Total $40.00 __________ SPECIAL Discount
for New Members – No patch or pin Without Magazine $25.00 Includes Insurance
_______________ With Magazine $35.00
Includes Insurance __________ Annual Renewal Calculations
Annual Membership
Primary $45.00 *Insurance $15.00
Total $60.00 _______________ Additional Family
Member $20.00 Insurance $10.00
Total $30.00
____________ Existing Life Member Calculations Annual
Membership Primary
*Insurance Premium $15.00 Total $15.00 __________ Spouse
Life Member
*Insurance Premium
$10.00 Total
$ 10.00 ___________ Additional
Family Life
*Insurance Premium $
10.00
Total $ 10.00 ___________ NRA Membership Calculations NRA Member Yes ____ No
____
NRA #’s_____________________________ Renew / Join: Dues
$10.00 , with NRA Magazine $25.00 ,
____________ WFDA Patches, Pins,
Window decals, $5 ea______ Caps $15 ea ______ + shipping _________ Members outside of US Residing in Canada
add additional postage
$5.00 ___________ Residing outside
of US other than Canada add postage
$20.00 ________
Total amount due
$ _________ Please make your
check or money order to World Fast Draw Association, all fees outside of the US please use a U.S. Postal Money Order (or cash,
some money orders are very expensive) Send Dues to: Dan
Qualls
6000 Wilkins Ave
Oakdale, CA 95361-9797 Phone 209-847-0483
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