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USTA Membership Rebate Form 3

June 6, 2005 10:10 PM

Special Opportunity for all USTA members and USPTA and USPTR pros.

In an effort to grow the number of USTA memberships in the Wisconsin District, the Wisconsin Tennis Association is running a special rebate program and drawing from November 1, 2004 to June 30, 2005.

For each non-member (was not a member since 10/31/03) friend or player who becomes a member because of your effort, you will receive a rebate ($3 for junior, $5 for adult, $10 for family) and your name will be entered in a drawing with a grand prize of a trip for two to the 2005 US Open.* Only one person may receive credit for one new member.

What a great gift for a birthday, graduation, holiday, etc. You can copy the form below as many times as you want.

Send the form to John Jansky, WTA Executive Director, P. O. Box 498, Schofield, WI 54476.

Rebates will be issued during July 2005. *If more than 500 new memberships have been received, the drawing for the grand prize, plus other prizes will take place on July 15, 2005.

Your Name: _________________________________ Your USTA # _________________

Your Address: _______________________________ Your Phone # _________________

Your City ___________________________________  Wisconsin   Zip _______________

New Member 1 Status:

New Member Name: _______________________________________________________

New Member USTA # _________________________________

Date New Member Joined the USTA: ____________________

Check Here if New Member has Never Been a Member Before: (    )

Check Here if (    ) New Member was a USTA Member in the past

  (include date "old" membership Expired ____/____/____

New Member Type (please check one):  Adult   (   )   Junior (   )   Family   (   )

New Member 2 Status:

New Member Name: _______________________________________________________

New Member USTA # _________________________________

Date New Member Joined the USTA: ____________________

Check Here if New Member has Never Been a Member Before: (    )

Check Here if (    ) New Member was a USTA Member in the past

  (include date "old" membership Expired ____/____/____

New Member Type (please check one):  Adult   (   )   Junior (   )   Family   (   )

New Member 3 Status:

New Member Name: _______________________________________________________

New Member USTA # _________________________________

Date New Member Joined the USTA: ____________________

Check Here if New Member has Never Been a Member Before: (    )

Check Here if (    ) New Member was a USTA Member in the past

  (include date "old" membership Expired ____/____/____

New Member Type (please check one):  Adult   (   )   Junior (   )   Family   (   )

New Member 4 Status:

New Member Name: _______________________________________________________

New Member USTA # _________________________________

Date New Member Joined the USTA: ____________________

Check Here if New Member has Never Been a Member Before: (    )

Check Here if (    ) New Member was a USTA Member in the past

  (include date "old" membership Expired ____/____/____

New Member Type (please check one):  Adult   (   )   Junior (   )   Family   (   )

New Member 5 Status:

New Member Name: _______________________________________________________

New Member USTA # _________________________________

Date New Member Joined the USTA: ____________________

Check Here if New Member has Never Been a Member Before: (    )

Check Here if (    ) New Member was a USTA Member in the past

  (include date "old" membership Expired ____/____/____

New Member Type (please check one):  Adult   (   )   Junior (   )   Family   (   )

New Member 6 Status:

New Member Name: _______________________________________________________

New Member USTA # _________________________________

Date New Member Joined the USTA: ____________________

Check Here if New Member has Never Been a Member Before: (    )

Check Here if (    ) New Member was a USTA Member in the past

  (include date "old" membership Expired ____/____/____

New Member Type (please check one):  Adult   (   )   Junior (   )   Family   (   )

New Member 7 Status:

New Member Name: _______________________________________________________

New Member USTA # _________________________________

Date New Member Joined the USTA: ____________________

Check Here if New Member has Never Been a Member Before: (    )

Check Here if (    ) New Member was a USTA Member in the past

  (include date "old" membership Expired ____/____/____

New Member Type (please check one):  Adult   (   )   Junior (   )   Family   (   )

 

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