Page 15 - DVAuction Online Catalogs

MeMbership ApplicAtion Texas Deer Association
Personal InformatIon:
name:________________________________________________________
principal occupation: __________________________________________
spouse’s name: _______________________________________________
other household members?: ____________________________________
Mailing Address:_______________________________________________
______________________________________________________________
______________________________________________________________
referred By: _______________________________________________
Application Date: ______________________________________________
ranch/business name:_________________________________________
county:_______________________________________________________
shipping Address: _____________________________________________
______________________________________________________________
______________________________________________________________
home phone: _________________________________________________
cell phone: ___________________________________________________
e-mail: _______________________________________________________
business phone:_______________________________________________
Fax line: _____________________________________________________
Website: ______________________________________________________
Would you like to be included in the tda directory: ❏ yes ❏ no
type of operation check
high Fence ❏
low Fence ❏
traditional livestock ❏
native Wildlife ❏
exotic Wildlife ❏
other: ________________________________________
type of products and/or services check
consulting & Management services ❏
Fencing services & supplies ❏
hunting supplies ❏
package or lease hunts ❏
Game Feed & Accessories ❏
bottle raising/nursery ❏
Veterinarian ❏
other: ________________________________________
Are You interested in serving...
(check any below or call tDA for a complete list)
Annual conventions ❏
chapter Formation ❏
Fundraising ❏
north American Whitetail registry ❏
Membership Marketing ❏
legislative & regulatory Advisory committee ❏
Animal health Advisory committee ❏
scholarship committee ❏
type(s) of native species: ❏ Whitetail ❏ blacktail ❏ Mule Deer other: ___________________________________________________________
type(s) of exotic species: ______________________________________________________________________________________________________
are you a deer Breeder: ❏ Yes ❏ no are you in the CWd Program?: ❏ Yes ❏ no enrollment Date: _____________________
if yes, then permit no:__________________________ if no, would you like information on the cWD program: ❏ Yes ❏ no
*annual dues:
❏ $35 - Student
Official tdA Cap & Window decal, Six Issues of tracks
❏ $75 - SpOrtSmAn member
Official tdA Cap & Window decal, Six Issues of tracks
$125 - Active member
Official tdA Cap & Window decal, Six Issues of tracks, Voting rights,
Annual membership in directory
❏ $525 - trophy member
Official tdA Cap & Window decal, Six Issues of tracks, Voting rights,
Annual membership directory, 2 tdA Gate Signs
❏ $1,025 - Contributing member
Official tdA Cap & Window decal, Six Issues of tracks, Voting rights,
Annual membership directory, 2 tdA Gate Signs, tdA Antler-handle Knife
*lIfe-memBershIPs:
❏ $2,525 - Sustaining member
Official tdA Cap & Window decal, Six Issues of tracks, Voting rights,
Annual membership directory, 3 tdA Gate Signs, tdA Antler-handle Knife,
personalized tdA Jacket and mesquite plaque
❏ $5,025 - donor member
Official tdA Cap & Window decal, Six Issues of tracks, Voting rights,
Annual membership directory, 4 tdA Gate Signs, personalized tdA Jacket,
mesquite plaque, tdA personalized travel bag & Leather portfolio
❏ $10,025 - patron member
Official tdA Cap & Window decal, Six Issues of tracks, Voting rights,
Annual membership directory, 5 tdA Gate Signs, tdA Antler-handle Knife,
personalized tdA Jacket, mesquite plaque and tdA personalized Leather briefcase
memBershIP levels
Return to: TDA, 403 East Ramsey Ste. 204, San Antonio, TX 78216, Tel: 210.767.8300, Fax: 210.767.8401
A portion of TDA regular dues is not tax deductible as an ordinary and necessary business expense due to the extent that TDA engages in lobbying. The non-deductible portion is 25%.
*Included in the annual membership fees greater than the “Student” level are dues and other benefits as noted as well as a $25 donation to the TDA Political Action Committee (PAC). Only the $25 contribution to
TDA PAC is optional and may be deducted if not desired. This is a voluntary contribution, and a member will not be favored or disfavored by reason of the amount of the contribution or the decision to contribute.
NOTe: CONTrIbuTIONS TO TDA PAC Are NOT DeDuCTIble fOr feDerAl INCOme TAx PurPOSeS.
❏ Personal Check or ❏ Corporate Check *amount Paid:_________________
Charge my ❏ Personal or ❏ Corporate Card: ❏ m/C ❏ visa ❏ ameX ❏ disc
name on card: ____________________________________________________________
Account#: __________________________________________ exp. Date: _____/_____
signature: __________________________________________ security#: ___________