Join TSRA

TSRA MEMBERSHIP APPLICATION

Please check one

__ New Application For Self __ Renewal For Self __ Gift Membership

Please Check One: TSRA Member Number __________ Recruiter's Number # R 174105

__ Annual Membership...............$ 25 __ Senior Annual (age 65+).......$ 20+ __ Family Membership..................$ 45 **

__ 3-year Membership................$ 65 __ Senior 3-year Membership....$ 55 + __ Annual Family Membership upgrade

__ Life Membership....................$ 400 __ Senior Life (age 65+)............$ 200+ for existing Life/Endowment/Benefactor

__ Conditional Life Membership...$ * Member..................................$ 20 **

__ Distinguished Annual............$ 20 *** __ 3-year Family membership........$ 100 ***

__ Defender Membership............$ 2,000 __ Distinguished 3-year.............$ 55 *** __ 3-year Family Membership upgrade

__ Benefactor Membership.........$ 1,000 for existing Life/Endowment/Benefactor

__ Endowment Membership........$ 700 __ Junior (age 20 and less).........$ 3 + Member...................................$ 55 **

__ Business/Club.......................$ 50 **** Receive $5 recruiting fee for each new member sponsored

Dues Rates effective 5/1/2007. Membership Dues are subject to change without notice.

* Down payment of $40 or more, balance paid within 2 years. ** Provide (use separate sheet) names and birthdates of family members..

*** Distinguished members are those disabled in military service. + Provide birthdates for senior and junior memberships: ____________________

______________________________________________________________

Name: Mr./Mrs./Ms. ___________________________________ Address: __________________________________________

City: _________________________________ State: _________ Zip: ___________ Phone ( ) _______________________

YES! Place me on the email alert list! Email Address: ___________________________________________________

Payment Information Check Enclosed # _____________ Visa MasterCard Discover AMEX

Account Number: _____________________________Exp. Date: ___________ Signature: _____________________________

Make checks payable to TSRA. Complete and return the application to TSRA 314 E. Highland Mall Blvd. #300, Austin, TX 78752,

Or fax application with credit card information to 512-615-4123.