TEXAS DEER ASSOCIATION
PERSONAL INFORMATION:
Name:__________________________________________________________
Principal_Occupation:_ ______________________________________________
Spouse’s_Name:___________________________________________________
Other_household_members?:_ _________________________________________
Billing_Address:_ __________________________________________________
______________________________________________________________
______________________________________________________________
Referred_By:______________________________________________________
Application_Date:_ _________________________________________________
Ranch/Business_Name:______________________________________________
County:_ ________________________________________________________
Billing_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_
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Native_Wildlife_
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Exotic_Wildlife_
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Other:_
_ ______________________________________
Type of Products and/or Services
Check
Consulting_&_Management_Services_
❏
Fencing_Services_&_Supplies_
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Hunting_Supplies_
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Package_or_Lease_Hunts_
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Game_Feed_&_Accessories_
❏
Bottle_Raising/Nursery_
❏
Veterinarian_
❏
Other:_________________________________________
Are You Interested in Serving?
Check
(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:__
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❏
_Whitetail____
❏
❏
_Blacktail____
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❏
_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 Directory
❏
$525 - TROPHY MEMBER
Official TDA Cap & Window Decal, Six Issues of Tracks, Voting Rights,
Annual Membership Directory, Two TDA Gate Signs
❏
$1,025 - CONTRIBUTING MEMBER
Official TDA Cap & Window Decal, Six Issues of Tracks, Voting Rights,
Annual Membership Directory, Two 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, Three 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, Four 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, Five 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 SUITE 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_estimated_to_be_100%.
*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.
MEMBERSHIP APPLICATION
PAYMENT INFORMATION:
*Amount_Paid:_ ___________________________________________________
❏
Personal_Check_
❏
_Corporate_Check
❏
Personal_Credit_Card_
❏
_Corporate_Credit_Card
❏
Mastercard_
❏
_Visa_
❏
_American_Express_
❏
_Discover
Name_on_Card:________________________________________________
Card_Number:_______________________________ __Expiration_Date:__ _____
Signature:_____________________________________Security_Code:__ _____
