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BE A PART OF
AMERICA’S COWBOY SPORT
Become a Member of the USTRC 2011 Membership Application
Membership active as of September 1, 2010 and expires December 31, 2011. Take advantage of joining online at ustrc.com or complete the application below. Indicate in the boxes the number of memberships at each level for which you are applying. PLEASE PRINT OR TYPE. Qty
Fee Gold Plus Membership USTRC’s Premier Membership Package. Available to adults 18 and older. Must be 21 or older to rope in Gold Plus ropings.
$300
Gold Plus Upgrade Must be a current Gold Spur member
$200
Gold Spur Membership USTRC’s Standard Membership Package. First-time member.
$100
Additional Family Membership Please list names and information on this application form. One SuperLooper Magazine subscription per household.
First Name
MI
Name to appear on card Male
Female
USTRC ID # (if renewing) First time members must contact classifications dept.
Occupation (i.e. rancher, teacher, mgmt…)
City/State/Zip
$50 Each
Country Home Phone
$40
Work Phone
Cell Phone
Gold Plus Family Members / Gold Spur Family Members Must be an immediate family member, spouse or children, living at home age 20 and younger at the time of application First Name
MI
Last Name
Name to appear on card Male
Female
Birth Date
Email Address
USTRC ID # (if renewing)
International Gold Spur Membership
$120
Relationship to member
Jr. Looper Membership Available to youth 12 and under at the time of application. Valid age documentation and social security number required.
FREE
First Name
Lifetime Gold Spur Membership Available to members 70 and older within the 2011 calendar year.
$100
SS# (required)
MI
Last Name
Name to appear on card Male
Female
Birth Date
Email Address
USTRC ID # (if renewing)
Lifetime Gold Plus Membership $200 Available to Lifetime members only. Requires annual renewal. Total $___________
USTRC Membership P.O. Box 1198 Stephenville, TX 76401 Phone 254.968.0002 Fax 254.968.0003
SS# (required)
Address
No.___ Heeler
Please make check or money order payable to USTRC and mail to:
Birth Date
By providing USTRC your email address, you give permission for USTRC to send important member updates and information. You may opt out at any time.
I am requesting a double number as a
Payment Information
Last Name
Email Address (required)
First Time or Expired Double Number Must be classified as a #5 or higher. Application fee non-refundable. No.___ Header
Personal Information (Primary Member)
SS# (required)
Relationship to member First Name
MI
Last Name
Name to appear on card Male
Female
Birth Date
Email Address
USTRC ID # (if renewing)
SS# (required)
Relationship to member Please provide the following information when paying with Visa, Mastercard or Discover Carholder Name Card # Visa
Mastercard
Discover
Exp. Date
Security Code
Signature
We’re happy to accept your credit card application over the phone at 254.968.0002 or join online at ustrc.com.
USTRC memberships are NON REFUNDABLE, NON TRANSFERABLE. All memberships expire December 31, 2011, with the exception of membership purchased after August 31, 2011 and before January 1, 2012. Membership purchased during that time will be valid until December 31, 2012. Allow 3-4 weeks for processing. Allow up to 6 weeks for delivery of SuperLooper Magazine. USTRC reserves the right to obtain a payment electronically for any check or other instrument you send by initiating an ACH (electronic) debit of the amount of your check or instrument to your account. Your check or instrument will not be returned to you by USTRC or your bank. Your bank account may be debited the same day payment is received.
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