TLBAA Membership Application
Texas Longhorn Breeders Association of America
P.O. Box 4430 - Fort Worth, TX 76164
Ph: (817) 625-6241 - Fax: (817) 625-1388
www.tlbaa.org
New active membership includes new member welcome package.
Included in your membership is a subscription to the Texas Longhorn Trails. Subscription rate is $60 US address or $75 foreign address.
TLBAA membership dues may be deducted as an ordinary and necessary business expense; however they are not deductible as a charitable contribution.
Membership Number
*
Name
Name which will appear on certificates and listing in TLBAA directory.
Other Name
*
Address 1
Address 2
*
City
*
State/Province
*
Zip/Postal Code
Country
*
Home Phone
Office Phone
*
Email Address
Website Address
New Active Member
$100.00/year
Renewal Active Member
$100.00/year
LATE ACTIVE MEMBER RENEWAL (After Aug. 31)
$125.00
Lifetime Member
$1000.00
New/Renewal Junior Member (18 yr. & under)**
25.00
** Junior Member Birthday
** SSN
New/Renewal Outrider (Associate Member)
(pays Non-Member rates for animal work)
$75.00
Charter Lifetime Outrider
$1000.00
Monthly Breed Publication (
Texas Longhorn Trails
)
(magazine subscription not included in Junior membership)
Included
*Drawing or Reading of Brand
PAYMENT/CARDHOLDER INFORMATION:
*Bill My:
Visa
Mastercard
*
Cardholder Name
*
Card Number
*
Expiration Date
01
02
03
04
05
06
07
08
09
10
11
12
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
*
CID
(last 3 digits on back of card)
*
Email Address
(to send confirmation)
*
Phone Number
If you have any problems submitting this form, please e-mail
tlbaa@tlbaa.org