Delaware Valley Combined Training Association

Affiliate Member, United States Eventing Association (USEA)
Charter Group Member, United States Dressage Federation (USDF), GMO# 121

Delaware Valley Combined Training Association

	Membership Registration

	Your Membership Entitles You To:
	Reduced fees at DVCTA schooling shows, clinics and events Earn "DVCTA Dollars" for volunteer time Group membership in USDF and all its benefits "USDF Connections" monthly magazine DVCTA Newsletter "TOP LINES" and email updates on events Eligibility to vote in yearly local elections Eligibility for DVCTA scholarships
	To join, type in your information below, print form and send with a check for the appropriate amount payable to DVCTA, Inc. to:
	Elsie Kellerman
	256 Old Kennett Road
	Kennett Square, PA. 19348
	Membership year is Nov. 1 - Oct. 31.
	You are considered paid through the following year if you join after Aug.1.



Name:
Select One:	Mr. Mrs. Miss. Ms. Dr. Other
Date of Birth:	--
Select One:	New Member Renewal Rejoining
If you are a former member, now rejoining under a different name, please provide your
previous name:
Address 1:
Address 2:
City:
State:	Zip:
E-mail:
Home Phone #:
Cell Phone #:
Check if DO NOT want your information published in our membership directory
Check if DO NOT want to receive the newsletter via US MAIL. If checked, you will receive the newsletter via Email only
Check if you are an instructor/trainer and would like information on inclusion in our DVCTA Instructor/Trainer Directory

Type of Membership:
Individual Membership (includes USDF Group Membership) $45.00
Family Membership
Primary Member (Receives USDF Group Member benefits) $45.00 Additional Members (Receives DVCTA benefits only) each $15.00
Primary Name: Additional: Additional:
Are you a Member of USEF? Yes No Membership#:
Are you a Participating Member of USDF? Yes No Membership#:
Are you a Member of USEA? Yes No Membership#:

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