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 ($25)
                                ___  Family * ($30)
                                ___  Senior Citizen ($10) + $5 for Family (60 yrs +)
                                ___  Lifetime:  ($300)

*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