NORTH AMERICAN DEVON ASSOCIATION    

APPLICATION FOR MEMBERSHIP  

 

To join the North American Devon Association,
complete this form and mail with applicable dues to:

North American Devon Association
PO Box 55
Hume, VA 22639 (540) 364-3444

 I (we) hereby make application to the Board of Directors of the North American Devon Association for Regular Membership and agree to abide by the By-laws, Regulations and Rules of the Association.  By signing this application, applicant waives any claim against the Association or any member, employee or agent of the Association, for any act or omission in connection with the Association.  It is requested that membership be entered as follows:

Membership Name (print)__________________________________________________

If firm or corporation, responsible party _______________________________________

Mail Address_____________________________________________________________

                        PO Box or Street                             City           State     ZIP      Country

Phone  (home)_________________________ (business)__________________________

E-mail__________________________________________

Birth date (Junior Member 18 or under only)______________________

Signature and date_________________________________________________________

Membership fee schedule: 

Lifetime Membership       $1000.00

Regular Membership          $100.00

(Renewal Membership         $50.00)

Associate Membership       $40.00

Junior Membership              $20.00

Business Membership       $100.00