Membership Form
Print this form out and send it in with your dues.

Date:_______________

Name:__________________________________________

Street Address:___________________________________

                     ___________________________________

City, State, ZIP:__________________________________

Home Phone #___________________________________

Work Phone #___________________________________

Cell Phone #___________________________________

E-mail address:__________________________________

Dues:   box One year - $20       box Lifetime Membership - $100

box New Member       box Renewal  (Member #_________)

Shirt size__________

Mail this form with your check or money order made payable to
Tulsa Disc Sports Association to:

Michael Treat
13333 W. 41st St.
Sand Springs, OK   74063

Thank you for your support.