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WEST VIRGINIA TAXIDERMY ASSOCIATION
2010 MEMBERSHIP & REGISTRATION FORM
NAME________________________________________________
SPOUSE AND FAMILY NAMES(FOR NAME TAGS)__________________________
BUSINESS NAME___________________________________________________
ADDRESS_________________________________________________________
CITY, STATE, ZIP CODE_____________________________________________
PHONE NUMBER_________________EMAIL ADDRESS______________________
MEMBERSHIP DUES
DUES: (CHECK ONE) ____$35.00 SINGLE
____$45.00 MEMBER AND FAMILY
LIFETIME MEMBERSHIP: ____$175.00 TWO YEAR OPTION
____$350.00 FULL PAYMENT OPTION
LIFETIME MEMBERSHIPS MUST BE PAID WITHIN A TWO YEAR PERIOD. IF THEY ARE NOT PAID OFF IN TWO YEARS, YOUR MEMBERSHIP ACCOUNT WILL BE CREDITED WITH WHAT YOU HAVE PAID AND WILL GO TOWARDS DUES UNTIL EXHAUSTED. SORRY NO REFUNDS.
CONVENTION FEES
____$35.00 SINGLE(AFTER MARCH 15, 2010 - $45.00)
____$40.00 MEMBER AND FAMILY(AFTER MARCH 15, 2010 - $50.00)
____$21.00 ONE DAY SINGLE
____$24.00 ONE DAY FAMILY
MOUNT FEES
COMMERCIAL MOUNTS ____x $10.00 EACH=_____________
(AFTER MARCH 15, 2010 - $15.00 EACH)
COMPETITION MOUNTS _____x $15.00 EACH=_____________
(AFTER MARCH 15, 2010 - $20.00 EACH)
YOUTH ENTRY ____x $10.00 EACH=_____________
(AFTER MARCH 15, 2010 - $15.00 EACH)
BEST ALL AROUND TAXIDERMIST ____YES ____NO $25.00______
CIRCLE ONE: PROFESSIONAL OR MASTERS
PRESIDENT'S AWARD ____YES ____NO $10.00_______
COLLECTIVE ARTISTS ____YES ____NO $15.00_______
(AFTER MARCH 15, 2010 - $20.00 EACH)
HABITAT ____x $10.00 EACH______________
WE WILL AGAIN BE HAVING A COMPETITORS AWARD(4 MOUNTS OF YOUR CHOICE)
MASTERS DIVISION-1ST PLACE $300.00
2ND PLACE $200.00
PROFESSIONAL DIVISION-1ST PLACE $300.00
2ND PLACE $200.00
COMPETITORS AWARD ____YES ____NO $30.00
CIRCLE ONE: PROFESSIONAL OR MASTERS
BANQUET TICKETS
_______x$30.00 EACH =_______
YOUR CHECK NUMBER________ TOTAL ENCLOSED_______
MAKE CHECKS OR MONEY ORDERS PAYABLE TO:
WEST VIRGINIA TAXIDERMY ASSOCIATION
PLEASE DO NOT SEND CASH.
FOR ALL PRE-REGISTRATIONS PRINT THIS FORM, FILL OUT, AND MAIL TO:
DONNA DEMARCO
RT 3 BOX 17B
SHINNSTON WV 26431
IF THIS IS YOUR FIRST TIME COMPETING, PLEASE INQUIRE AT THE REGISTRATION DESK ABOUT JUDGING AND CRITIQUING OF YOUR PIECES
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