ASA Membership Renewal

ASA Membership Renewal Request

This is a form for renewing membership in the ASA.
Date*
Month
Day
Year
Name*
First Last
Spouse or Partner's Name
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Is the above address new in the last year or so?*
If yes, we will update our database!
Preferred Phone for Contact*
Email*
Is the email above new in the last year or so?*
If yes, we will update our database!
The Ameri-Can Stabyhoun Association has no paid staff and is run entirely by member volunteers. If accepted for membership in the ASA, I would be willing to volunteer:*
- Yes
- No
- Perhaps occassionally
My special interest and skills are:
Would you like your contact information to appear in the “Membership Directory” which appears in the “Members Only” section of the ASA website? It will assist other Staby owners close by to get in touch with you for gatherings and play dates! Please indicate:*
- YES
- No
I hereby renew my membership in the Ameri-Can Stabyhoun Association, and by signing this application agree to abide by the ASA Constitution, Bylaws and Code of Ethics found on the ASA website (www.stabyhouns.org). Please check the box..*
I agree to the above statement.
Choice of term for membership*
Payment Method*

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Membership year runs from July 1 to June 30st. All memberships approved on or after April 1 will be applied for the balance of the current and the following year. You will be redirected to the PayPal site to pay.
PLEASE NOTE THAT MEMBERSHIP IS NOT AUTOMATIC AND IS DETERMINED AT THE DISCRETION OF THE BOARD. If for any reason your membership application is denied, we will refund your application fee.
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ASA Membership Renewal

ASA Membership Renewal Request

This is a form for renewing membership in the ASA.

Membership year runs from July 1 to June 30st. All memberships approved on or after April 1 will be applied for the balance of the current and the following year. You will be redirected to the PayPal site to pay.

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