Membership Application

Membership Application Membership Date
Name
Home Address	Phone
City	State Zip Code
Company Name
Address	PhoneCell
City	State Zip Code
E-mail	Spouse's Name
Please choose the address where you would like to receive information: Home Company
Please let us know what information you prefer to receive from us -
Active Member - I want to receive invitations to monthly meetings, and to the activities I have checked below:
Golf - I want to receive information about the Golf Tournament only.
Roping - I want to receive information about the Roping event only.
Clay Shoot - I want to receive information about the Clay Shoot only.
Print this form and mail with $20.00 check to: Victoria API, PO Box 5275, Victoria, Texas 77903-5275