Application for Membership

MR MS MRS

Title/Rank/GradeOrg.

Name    (First)	(MI) (Last)
Street Address
City	State Zip Code
Work Phone	Home Phone
E-Mail Address	(work)(home)
Birth Date (A-35 If under age 35)	Sponsor's name Chapter: San Antonio

 Renewal will be on anniversary month of joining NDTA.  Membership includes subscription to the Defense Transportation Journal

Membership Type (Check applicable)  $400.00 – LIFE            $99.00 Regular (3 Years)      $35.00 Regular (1 Year) 

$20.00 Special Rate (1 Year):   (Check the applicable category:) Military(Pay Grade 03 & below  including enlisted)    

Active Duty  Active Reserve Active National Guard    Govt. Employee (Pay Grade GS-10 & Below)  A-35 (Under 35 Years of age)  Retired (Not gainfully employed)                                                    

$10.00 ( Full-time student) (1 year)                 

             Occupation (Check applicable)  

Air       Consulting     Education   Highway   Industry Traffic Management  

Lodging/Hospitality Industry Manufacturing Marine Military Pipeline  

Rail Technology Travel Industry   Other

 Amount Remitted (Please consider adding $1.00 for the Foundation)

Make checks payable to NDTA Check #  or include major credit card information below.

Name as shown on credit card:  

Type card (Visa/MasterCard/American Express)  

Card Number: Expiration Date:

 Signature_______________________________________________________________  

 Print and mail application with payment to:  Victor Wherry, 6720 Spearwood, Live Oak TX 78233.

Link to:  NDTA Purpose  San Antonio Chapter Home Page