LTCPA Membership Form

LTCPA Membership Form
Personal Information
Name*

First NameLast Name
Birthdate*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Cell Number*
Email*

Membership Information
LTCPA Membership Options*
Current CTCPA Rating*
Do you require a CTCPA Membership?*
CTCPA Membership Options
Home Association*

LTCPASTCPACATPAATCPSOther
Name and Rating

Payment and Terms
Total Amount Owing
How will you be submitting payment?*
Send Cheque: payable to Lakeland Team Cattle Penning Association Box 436 Irma, AB T0B 1B0

Etransfer: Send to lakelandteampenning@gmail.com. We are set up for autodeposit.
Should be Empty: