Membership Form

USBCHA Membership Application

See rules and bylaws of USBCHA for complete information on membership expectations. https://usbcha.com/governance/

Name*

Please enter the name format you plan to use at trials.

First Last

Year membership takes affect*

Membership expires December 31 of the current year regardless of when membership is paid. Select either current year or select next year to begin membership next January 1.

Membership Status*

Please select the type of action needed for this form

Type of Membership*

General: $25.00
Life: $250.00
Associate: $25.00

You must have competed in a USBCHA Sanctioned Open or Nursery trial to be eligible for General or Life membership. Associate membership does not require that you have competed in Open or Nursery but makes you eligible to receive qualifying points when you do compete. Associate members are not eligible to vote in elections. Your Associate membership will convert to General membership when you have competed in an Open or Nursery class with no additional payment required.

Name of trial*

To be eligible for Life or General Membership, you need to enter the name and date of an Open or Nursery Trial that you competed in within the last 2 years

Date*

Contact changes*

New Address
New phone
New email
All contact info given previously is correct

If you are unsure whether your contact information is correct, please check new and fill out the correct information

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Alternate Phone

Email

Necessary if you wish confirmation of you membership and/or to be on the group email list

Enter Email Confirm Email

I would like to be on the USBCHA group email list. (Vertical Response)*

Yes
No

Note: you can sign up for the group email list at any time by notifying the USBCHA secretary at secretary@usbcha.com. You can unsubscribe at any time. The group email is used to send out election information, ballots, finals entry forms and other information pertinent to members. All information and forms can also be accessed on the USBCHA website.

Payment Choice*

Mailing Check: membership begins based on postmark
PayPal: membership based on date of payment. There will be a small convenience charge added
Payment given to officer or director of USBCHA at a trial previous to your run

After submitting this form, you can either pay via PayPal on the membership page of USBCHA website or mail a check to: USBCHA 1556 Harding St Enumclaw, Wa 98022 Funds must be in US Currency