TEXAS JACK ASSOCIATION

Note: Membership in the Texas Jack Association is open to all interested persons. There are three basic types of membership:

• Individual adult membership- $25/person
• Junior memberships (under 18) - $10/person
• Family memberships (all persons residing at same address) - $40/family

SEND TO:

Texas Jack Assn.
Rene Tyree, Treasurer
244 NW Whitlock Dr.
Lee’s Summit, MO 64081

I have enclosed $________for the following membership(s) in the "Texas Jack" Association.

NAME: _______________________________________

ADDRESS: ____________________________________

_____________________________________

E-MAIL:______________________________________

PHONE: (_____) __________

___NEW MEMBERSHIP
___RENEW MEMBERSHIP

BIRTHDATE: ______________________

ARE YOU RELATED TO THE OMOHUNDROS? ____

IF SO, PLEASE GIVE LINEAGE: