Skip to main content
HomeMWD Membership Application

 

 

Midwest Division Application for Membership

Midwest Division of TCA, PO Box 327, South Elgin IL 60177

 

 

 

Date________________________

 

 

Name______________________________________________________________________________

 

Address____________________________________________________________________________

  

 

City___________________________________, State____________ Zip Code_____________________

 

 

Phone #______________________-____________-__________________________________________

 

 

National TCA #_______________________________________________________________________

 

 

E-Mail Address__________________________________@______________________._____________

 (Your e-mail address will be used for MWD information only)

 

 

Membership Fee $30.00 covers MWD yearly dues and door fees for all MWD meets.

 

Family Membership is an additional $5.00 to the Regular or Annual membership fee. This allows your

 

spouse and any children under 17 years of age free admission

 

 

Total Check Amount $ ___________________

 

 

Family Membership Information:

Spouse (Name)______________________________________________________________________

MWD Sponsor (Name) TCA#

 

(Children ages 17 and under free - Please List Names and Ages)

 

Child (Name)____________________________________________________Age_________________

 

Child (Name)____________________________________________________Age_________________

 

Child (Name)____________________________________________________Age_________________

  

 

Send completed application with payment to:

Midwest Division TCA

P.O. Box 327

South Elgin, IL 60177