WSAA Membership Application FIRST NAME

MI

LAST NAME

City

State

ZIP

Home Phone

E-Mail (REQUIRED)

SUFFIX

Address

(

New

Renewal

Name of WSAA affiliated Club (or Independent)

) WSAA

WSAA & NFAA

$30.00

$70.00

$10.00

$20.00

1 Add Junior (Under age 18)

$ 2.00

$ 12.00

2nd Add Junior (Under age 18)

$ 2.00

$ 7.00

$ 0.00 *

$ 5.00

$10.00

$25.00

Name

Birthdate (REQUIRED)

These rates only apply when ADDED to an Adult or Independent Junior membership

Adult Member 1st Add Adult (Spouse) st

rd

3 Add Junior (Under age 18)

Independent Junior (Under Age 18 without Adult)

(List additional junior members on back) Request The Quiver mailed to me at the address above

Total Enclosed: I will read The Quiver from the WSAA Website

Mail to: WSAA, PO BOX 176, NORTH BONNEVILLE WA 98639-0176 Make CHECK payable to WSAA Rev 1/18