VTA- Join NTA     print this form and enclose it with your payment mailed to:

National Trappers Association
2815 Washington Avenue
Bedford, IN  47421

Phone: (812)277-9670  Fax: (812)277-9672

E-Mail: http://www.nationaltrappers.com/

*Required Information

*Name____________________________________________________________
*Address__________________________________________________________
*City_____________________________*State_______*Zip_________________
*Daytime Phone(___)______________ Evening Phone(___)________________
*BIRTHDATE___/____/____      Email______________________________

Please check all that apply:                                 ____DO NOT SELL

New ______                  Renew______
___One Year NTA Membership     $30
___Two Year NTA Membership    $55
___Three Year NTA Membership  $80
___Junior NTA Membership          $15
___Family NTA Membership                   $15 (One household person must be a
                                                                           regular NTA member)
                                            Name of regular member:_____________________

US Lifetime NTA Membership (Under Age 70)
          ___$750/one-time payment
          ___Payment Plan 1: $75 down/bill me $75/9 months
          ___Payment Plan 2: $75 down/charge credit card $75/9 months

___US Senior Lifetime Membership (Age 70 and Older) $200
___US Lifetime Membership (No Magazine) $350

*Pay By:     ___Check   ___Credit Card

Credit Card Number:________________________ Exp. Date:___/___
Security Code:____       Signature:______________________________

Make check or money order payable to the National Trappers Association.

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