Membership Renewal

Complete the form below to renew your BCSA Membership. Review all information carefully before pressing "Submit Renewal." After you "Submit" your form, you will have the option of paying your dues with a credit card via PayPal or mailing your payment. * = Required Information

Renewal Exception

Memberships for those joining at the October 2017 meeting and forward through the December 2017 meeting do not expire until 12/31/18. No renewal is due at this time for these memberships.

Member Information

Name*

First Last

Household Name

Age*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email*

NOTE: — Members with an email address will receive the annual Membership Roster via email. — Make certain the Membership Chair is notified if your email address changes.

Member Preferences/Signature

Membership Type/Dues*

Meeting Notices

Agreement*

By selecting "AGREE," I agree to comply with the Code of Ethics, to support the Constitution and Bylaws, and to strive to fulfill the Mission and Vision of the Border Collie Society of America.

Applicant's Signature*

By selecting "YES," I confirm that it has the same effect of my personal signature.

Household Signature*

Select N/A if Individual Membership. Household Membership: By selecting "YES," I confirm that it has the same effect of my personal signature.

Notes

Enter any special notes needed.

PayPal or Mail Payment*

Total

$0.00

Membership Renewal Form