MEMBERSHIP APPLICATION
OKLAHOMA TAXIDERMISTS ASSOCIATION
Membership runs from convention to convention.
Secretary reserves the right to pro-rate a late membership.
OKTA special events will not be pro-rated.

Name: _________________________________________Date: ________________________

Address:  
___________________________________________________________________________

City: _______________________________ State _________  Zip Code: _________________

Phone (_____) _______-_________   E-mail: _________________  
Website:_____________________

Membership Options:
                             ___  Individual ($35)
                             ___  Family * ($40)
                             ___  Senior Citizen ($15) + $5 for Family (60 yrs +)
                             ___  Lifetime:  ($400)

*Family memberships apply only to people living in the exact same house as the member.
List Family Members:
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________
_______________________________

Please Print and return with payment to:
Janell Reid
OKTA Secretary / Treasurer
2787 County St. 2870
Chickasha, OK  73018