Membership Application
Utah Crossroads Chapter, Oregon-California Trails Association

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Please enroll me as a member of Utah Crossroads Chapter, OCTA. I understand I must also be a member of the national Oregon-California Trails Association.

Name_______________________________________________________________

Address_____________________________________________________________

City, State, ZIP________________________________________________________

Telephone____________________________________________________________

E-mail_______________________________________________________________

Select a category:

Individual membership $10.00 [_]

Student membership $5.00 [_]

Make check payable to "Utah Crossroads" and send to:

Gar T. Elison, Treasurer
Utah Crossroads
4681 West Villa View Dr. Unit C
West Valley City, 84120

Comments:

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Office use:

Date submitted ___________________

Date received & posted ____________