Tripoli West Texas Membership Application
- Full Members shall be dues paying, voting members, may hold office, may perform range control duties in accordance with TRA safety codes, and shall receive all benefits pertaining to TWT membership.
- Associate Members shall be dues paying, non-voting members, may perform range control duties in accordance with TRA safety codes, shall receive all benefits pertaining to TWT membership but may not hold office.
- Participating Members shall be dues paying, non-voting members, may not hold office, may not perform range control duties, but will receive all other benefits pertaining to TWT membership.
County of Residence (check one)
Andrews _______             Crane _______                Ector _______       Glasscock _______             Howard _______           Martin _______
Midland  _______             Pecos _______              Upton _______               Ward _______             Winkler _______             Other _________________________________
(explain other)
School Attending _______________________________________                                                      Grade ____________                                    Current Age ___________
Membership Type – Rate $12.00 Single $18.00 Family - Student & Special club rate if you join NAR / TRA (must be under 20 yrs.)
Membership is Janurary 1, current year to December 31, current year
(see membership section of the bylaws)
                                       Full _______________                                  Single _______________                                        Months remaining in current year _______________
Associate (out of area) _______________                                Family _______________                                                                    Pro-rate August _______________
                         Participating _______________                               Student _______________                                        Months remaining in current year
                                                                                                                                                                                     # of months ­­_________ X rate per year _______________
                                                                                                                                                                                                                Total Due _________________________
                                                                                                                                                                                                                Make checks payable to Teresa Ballard
Contact Information                                                                                                     Certification (if applies)
Daytime Phone _(____)__________________                                                              NAR # _______________                             Level _____              Expires __________
Evening Phone _(____)___________________ 
Cellular Phone _(____)___________________                                                             E-mail address _________________________________________________________
Name and Address
Name: ______________________________________________
Address: _____________________________________________
City: _______________________________________________ State: __________ Zip: __________
Membership in Tripoli West Texas entitles you to participate in all TWT activities. There are three categories of membership available. You must reside in one of the eleven counties below to be eligible for full membership.
TRA # _______________
Level _____              Expires __________
By submitting this application for membership I agree to conduct all rocketry activities in accordance with the TRA safety codes, NFPA 1122 and 1127, and all applicable local, state, and federal regulations. I will encourage others to do the same.
To submit your application, mail the completed form to the address below, or present it to a club officer at a club function.
____________________________________________________                                                          _________________________________________________________
Signature of Applicant                                                                                                                              Date of Application
Tripoli West Texas
James Ballard / Secretary
1816 Cord St.
Odessa, TX 79762                                                                                                                                    Assigned Member # ________________________________________
Tripoli West Texas Membership Application                                                           Revision Date 2/10