Online Membership Application

Online membership application for New Members Only.
 Current Members, Do Not Use This Form.  Please login to your account if you need to Renew membership.  If you do not have a login please contact Lynn Kraut: Ausslyn@aol.com

Error: First Name is required.

Error: Last Name is required.

Error: Street Address is required.

Error: City is required.

Error: State is required.

Error: Zip Code is required.

Error: Country is required.

Error: Phone Number is required.

Error: Email is required.

Error: Please pick Membership Type

Error: Junior Birthdate or Junior AKC number is not correct or missing

Error: Please except Terms and Conditions

Contact Information

First Name:  
Last Name:
Street Address:  
Address Line2:
City:  
State:  
ZipCode:
Country:
Phone Number:
Email:

Areas of Interest?

Pet   Breeding   Obedience   Rally   Conformation
Herding   Search And Rescue   Tracking   Agility
Judging   Handling   Stewarding   Rescue

Are you interested in a Member Club?

Would you like to recieve the USASA Email Newsletter?

Membership Type

Individual member (Journal, 1 Vote) - $60.00
Dual member (Journal, 2 votes) - $75.00
     Co-applicant First Name:      Co-applicant Last Name:


Canadian member (Journal, no vote) - $95.00
Foreign member (Journal, no vote) - $110.00
Jr member (no Journal, no vote) - $0.00
Jr date of birth: 
Jr AKC Number

Have you previously been a member?
No     Yes

Journal mailing Class

3rd Class
Canada
Foreign
1st Class (US Only) $15.00

 By submitting this application I agree to abide by the Constitution, By-Law's and the Code of Ethics of the United States Australian Shepherd Association and I am in good standing with the American Kennel Club.

Please check that your information is correct. When you click SUBMIT your application information will be sent to USASA and you will be directed to the payment page (Juniors will be directed to a confirmation page).

United States Australian Shepherd Association