WFDA NEW-
MEMBERSHIP FORM
Date: ______________
Member Name _____________________________________________ DOB
_______________
Phone # __________________ Cell ___________________ Email________________________
Address _______________________________________________________________________
State/Prov_____________________Country_______________________Zip ________________
Member Spouse Name_____________________________________
DOB ______________
Additional Family Names _____________________________________
DOB ______________
Sponsor_______________________________________________________________________
*** 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
$20.00 *Insurance $10.00 Initiation $10.00
Total $40.00
___________
SPECIAL
2010 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 $25.00____________
Supplies
WFDA Patches, Pins, Window decals,$ 5.00
ea_______ Caps $10 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 $______________
The Association Thanks You for your Membership and Support
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.
Send Dues to: Dan Qualls
6000 Wilkins Ave
Oakdale,
CA 95361-9797
Phone 209-847-0483