KENTUCKY TAXIDERMIST ASSOCIATION INC. Membership Application Name _________________________________ Shop Name _________________________________ Address _________________________________ Telephone _________________________________ Cell # _________________________________ Home # _________________________________ Email address _________________________________ Is this your first membership with the K.T.A.? YES NO KTA dues are $60 annually Make checks payable to KY Taxidermist Association and mail to our current treasurer: Brian Bliese 5010 Prosperity Lane Hopkinsville, KY 42240 Please tell us about yourself, your shop, full time, part time, hobbies, awards, achievements, family, or anything else you would like to share with us. __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ If you are online, you can check us out on the web at www.kytaxidermy.com |
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| Hold mouse pointer over application ..right click...then click on Print. Send Application with $60 dues to address below |
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| MEMBERSHIP APPLICATION: |