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USATF-NE Membership Application
November 1, 2012 to December 31, 2013

To join USA Track & Field - New England, fill in the application below, print it, and send with a check to USATF-NE, P.O. Box 1905, Brookline, MA 02446-0016. Your number is assigned right away. If you indicate an email address, the information will be emailed to you. Membership cards are mailed from the National office and take 3-4 weeks.

The membership fee remains the same as 2013 (and the past 7 years).
There is an adult discount when signing up _online_ for multiple years (see www.usatf.org)

Membership Fees for 2013
$30 for Athletes 19 & older, Coaches, Officials, Supporters
$20 for Athletes 18 & younger
First Name: Date of Application:
Last Name:
Address:
Town/City: State:
Zip:
E-mail: Telephone:
Date of Birth:
Sex: FemaleMale U.S. Citizen: Yes No
Type: Athlete Coach Official Supporter Citizenship if not US:
Events:
Track & Field Long Distance Running
Racewalking
 Cross Country
Mountain/Ultra/Trail
Club Name: Club Number:
Please direct my additional contribution to
$ Youth Athletics $ Specific Program (list) $ Specific Program (list)

I certify that in accordance with the rules of the IAAF & USATF, I am eligible to compete in the indicated sport.

Signature: ______________________________     Date: _____________

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