AZ USATF Individual Membership Application

General Instructions:

This screen accepts membership information. After the screen has been filled in, select "Form Complete", print, sign, and send to USATF/AZ.
Notes:
1. All fields are required except for Initial, Phone, E-Mail, and Club.
2. If the printed form will not fit on one page (Use Print Preview to check) make the font size smaller.
    In IE: Choose View --> Text Size. In NN: Choose View --> Decrease Font.


New Member Renewal from last year  (Previous USATF Number: )
Name
First Initial Last Suffix
(Jr, Sr, etc.)

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Home Address:
Street
Street 2
City
State
Zip Code -

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Phone: ( )   - Ext.
E-mail: (
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Personal Information
Birth Date:
Gender:  Male Female
Country of Citizenship:
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Arizona USATF Registered CLub
Club Name:
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Sports Codes (Check all that apply)
Track Events Road Running / Long Distance
Field Events Ultra-marathon running
Cross Country Mountain / Trail
Race Walking
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Membership Categories (Check all that apply)
Athlete Parent
Diabled Athlete Administrator
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Fee Calculation
$20 per year for Youth, $30 for Adults
Your tax-deductible donations/contributations are always welcome.
   Junior Olympics $
   National Programs $
   Local Association $

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Click "Form Complete" when you have finished entering your information. A summary of your information will appear in a new window which you can print out and then sign.