Please Print this page

MEMBERSHIP APPLICATION
5617 East 30th
Tucson, AZ  85711


MEMBERSHIP STATUS:  NEW ______ RENEWAL _____ NTA MEMBER #              

NAME ______________________________ £ DATE OF BIRTH ____________£

BUSINESS NAME  _______________________________________________________________£

 ADDRESS ____________________________________________________________£

 CITY ________________________________£         STATE _______  £ 

ZIP _______________£

TELEPHONE (DAY) _____________________ £ (NIGHT) ___________£

EMAIL ADDRESS: ____________________________  £
WEBSITE: ______________________________£

The ATAA is an Affiliate Representative of the National Taxidermist Association, Slidell, LA.  The NTA includes a $10,000 Accidental Death Insurance policy and the Outlook magazine with your membership. 

Please issue insurance policy in this name:  _________
(Above for Business and Family memberships only)

SPONSORED BY (OPTIONAL): __________________________________________________________

 MEMBERSHIP CATEGORY

________ U.S. Individual ATAA Membership $35.00   
________ U.S. Individual NTA Membership $50.00

________ U.S. Family ATAA Membership $45.00
________ U.S. Family NTA Membership $70.00

Please mail to: ATAA c/o Gail Tout, Secretary
                           5617 East 30th
                           Tucson, AZ 85711.
 
Make checks payable to:  A.T.A.A.
 

 For more information, please contact Gail Tout (520) 790-1054.

The ATAA hosts a website: taxidermyataa.com.  Please indicate
with a check mark in the □ on each line above if you would like to include the information under the member listing on the ATAA website.