Secure On Line Signup

United States Practical Shooting Association
P.O. Box 811
Sedro Woolley, WA 98284
USA
(360) 855-2245 (voice)
(360) 855-0380 (fax)
www.uspsa.org
General info: office@uspsa.org
Memberships: orders@uspsa.org

You may use this form to join USPSA on-line and become immediately eligible for all benefits of USPSA membership. Your order will be processed using state of the art secure communications technology - your credit card number will be securely encrypted when it is transmitted to our web server. If you prefer, we also accept new memberships via phone, fax or postal mail.

If you have any questions about or procedures for security of your credit card number, please visit our security information page.

If you have any questions about your membership application, you may email our membership coordinator, or phone/fax/email us at the above address. Foreign members may participate in the USPSA Classification System, but are not eligible to vote in USPSA elections.

Once you have submitted your application, you can expect to receive your new member packet in about a week. Upon submission of your application, you are immediately eligible for all member benefits, including participation in USPSA events, and inclusion in the USPSA classification system.

When you join on-line, you will be given immediate access to the "members only" area of this web site, as well as a personal PIN which will allow you to use our "members only" classified ad system. This "immediate access" feature is available only when you join using the on-line system and pay by credit card.

Your birthday is optional. We ask for your birthday so that we may place you into the appropriate category (Junior, Regular, Senior) and automatically update this information each year based on your age. Our classification database and match results will indicate if you are categorized as a "Junior" or "Senior" competitor, however, your birth date will not be publicly released.

You may also Join USPSA by postal mail or fax.

USPSA Secure On Line Order Form

Member's First Name:

Member's Last Name:

Credit Card Holder First Name:
(if different)

Credit Card Holder Last Name:
(if different)

Sex:

Male Female

Date of birth (optional):

/ / MM/DD/YY format

Address:

City:

State:

Zip/Postal Code:

Country:

Phone:

Email:

Membership Type:

U.S. Annual	$40.00 US Dollars
U.S. 3 Year	$105.00 US Dollars
U.S. 5 Year	$175.00 US Dollars
U.S. Life	$500.00 US Dollars
U.S. Annual Associate^*	$25.00 US Dollars
U.S. 3 Year Associate^*	$75.00 US Dollars
U.S. 5 Year Associate^*	$125.00 US Dollars
Foreign Annual	$50.00 US Dollars
Foreign 3 Year	$135.00 US Dollars
Foreign 5 Year	$225.00 US Dollars
Foreign Associate^*	$35.00 US Dollars
3 Year Foreign Associate^*	$105.00 US Dollars
5 Year Foreign Associate^*	$185.00 US Dollars
Foreign Life	$600.00 US Dollars
Benefactor	$1000.00 US Dollars

*	Associate memberships are available to US residents who share a household with a non-associate US members. Associate members are entitled to all benefits of USPSA membership, but do not receive a copy of Front Sight magazine.

Status:

New Member Renew membership

Check Renew membership if you have ever been a USPSA member and enter your former USPSA number if you have it available.

USPSA Number: (renewals only)

Comments:

If you were referred by an existing USPSA member, please enter the data below.

Referring USPSA No.:

(if known, otherwise leave this blank)

Referring Name:

First: Last: