ASA Membership Renewal

ASA Membership Renewal Request

"*" indicates required fields

This is a form for renewing membership in the ASA.

Date*

Name*

First Last

Spouse or Partner's Name

First Last

Address*

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

Preferred Phone for Contact*

Email*

The Ameri-Can Stabyhoun Association has no paid staff and is run entirely by member volunteers. If accepted for membership in the ASA, I would be willing to volunteer:

Yes

No

Perhaps occasionally

My special interest and skills are:

Would you like your contact information to appear in the “Membership Directory” which appears in the “Members Only” section of the ASA website? It will assist other Staby owners close by to get in touch with you for gatherings and play dates! Please indicate:*

Yes

No

Choice of term for membership*

Payment Method*

Membership year runs from July 1 to June 30. All memberships approved on or after April 1 will be applied for the balance of the current and the following year. You will be redirected to the PayPal site to pay. If you prefer to send the ASA a check, the address is: Ameri-Can Stabyhoun Association c/o Phil Frey, Treasurer 1161 Kneese Road, Fredericksburg, TX 78624

PLEASE NOTE THAT MEMBERSHIP IS NOT AUTOMATIC AND IS DETERMINED AT THE DISCRETION OF THE BOARD. If for any reason your membership application is denied, we will refund your application fee.

Name

This field is for validation purposes and should be left unchanged.