Become a Member - Heartland Dallas Safari Club

Name

First Name *

Last Name *

Spouse's First Name

Spouse's Last Name

Youth First Name

Date of Birth

Youth Last Name

Youth 2 First Name

Date of Birth 2

Youth 2 Last Name

Mailing Address - 1 *

Mailing Address - 2

City *

State *

Zip/Postal Code *

Country *

Phone *

Email *

New or Renewal? *

This is a NEW membership This is a membership renewal

Please check here if you are between 23 and 45 and wish to be included in Conservation Society- DSC's Young Professionals Group

I wish to be included

NOTE: Individuals living in the counties of Dallas, Tarrant, Rockwall, Denton, Collin, Kaufman, Ellis, Johnson, Hunt, and Van Zandt must join as sponsor or spouse sponsor members. Individuals living outside of these counties may choose an Associate Membership, which has no DSC membership voting rights.

Please Check Your Membership Choice(s) Below

$75.00 ASSOCIATE MEMBER

$100.00 ONE YEAR NEW SPONSOR MEMBERSHIP SHOW SPECIAL - GOOD DEAL!!

$175.00 TWO YEAR NEW SPONSOR MEMBERSHIP SHOW SPECIAL - BETTER DEAL!!

$250.00 THREE YEAR NEW SPONSOR MEMBERSHIP SHOW SPECIAL - BEST DEAL!!

Membership Total

Total:

If you would like to add Family Member(s), please select below

$25.00 SPOUSE SPONSOR MEMBER

$25.00 YOUTH MEMBER (23 & UNDER) *must list date of birth on top of form

Family Members

Total:

If you would like to upgrade to Lifetime Member, please select below

$1,500.00 LIFE SPONSOR MEMBER

$300.00 LIFE SPOUSE SPONSOR

Lifetime Members

Total:

Additional Donation

None

$25

$50

$75

$100

$250

$500

$1000

Additional Donation Total

Total:

Corporate Membership

$500 CORPORATE MEMBER

*5 Designees Included

Names of Designees 1

Names of Designees 2

Names of Designees 3

Names of Designees 4

Names of Designees 5

Corporate Membership

Total:

Professional Membership

$75.00 MEMBER

*Guide or Outfitter Only

Professional Membership

Total:

Overall Total

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Overall Total:

Heartland DSC

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