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BTA MEMBERSHIP APPLICATION/RENEWAL

Family ………. $20
Single ……….. $15
Junior (under 18) ..$5
Patron ...........…$25 or more
How did you hear about the BTA?

[   ] Chamber of Commerce [   ] Newsletter
[   ] Friend [   ] Newspaper [   ] TV

List names of all members joining:

___________________________________     ____________________________________

___________________________________     ____________________________________

Address: ______________________________________________________

City, State, ZIP __________________________________________________

Phone: Home ____________________Work________________________

 

Please list anyone else who might be interested in joining the BTA:

Name: ____________________________________________

Phone: Home __________________Work__________________

 

Total enclosed $__________        Date_____________________

Print this form, enclose check (payable to BTA) and mail to:
BTA
Box 69
Bartlesville OK 74005