WPDA 2024 Membership Form

WPDA 2024 Membership Form
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Membership Status*

New MemberRenewing Member
Type of Membership*

Individual- $65Junior/Young Rider - $50Family - $25
For FAMILY membership, name WPDA member.
USDF #
Barn Name
If applicable, please check the following information to be included with you membership. (Check all that apply.)

Dressage TrainerDressage InstructorDressage JudgeTechnical DelegateBreeder
Our success starts with you! Please check any areas you'd like to get involved with.

MembershipRated ShowsWebsiteSocial MediaEducationJunior/Young Rider Program

Check Out*

WPDA Individual Membership

$65.00 Quantity

WPDA Junior Membership

$50.00 Quantity

WPDA Family Membership

$25.00 Quantity

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

If paying by check: make checks payable to Western Pennsylvania Dressage Association and send to:

Barbara Wozniak
102 Cyrstal Springs Drive
Cranberry Twp. PA 16066
Should be Empty: