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United Oriental Roller Association
MEMBERSHIP FORM
Lisa Rasmussen
134 East 300 North ,Spanish Fork, Utah 84660 ...Phone:435-201-0748


Please print out this form and mail to the above address. Individual yearly dues are $20.00. Family $25.00, and Junior (17 years and under) $10.00. Members are eligible for awards offered by the club.



NAME:____________________________________________________________________


ADDRESS:___________________________________________________________________

CITY:________________________________STATE:_____________ZIP CODE:__________

PHONE:__________________________E-MAIL:____________________________________


Other Pigeon Breeds you raise:____________________________________________________

Comments/Additional Information:_________________________________________________

________________________________________________

Remember all memberships are renewable on January 1st of each year. Please return this form to the Secretary/Treasurer when paying club dues.


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