Membership Application

TSDA Membership Form

Complete the following information. * only if applicable.
Name  
Mailing Address  
(continued)*  
Email Address  
Phone Number  
University  
Chapter Name  
Chapter Website*  
Advisor Name   
 

Select a member of your chapter to act as a TSDA Representative.  They will serve as the TSDA contact through out the school year. The representative may or may not be a chapter officer, however the representative does need to be available for contact throughout the entire school year.  

 

Chapter Representative  
Email Address  
Phone Number  

 

Dues are $7.00 per student and are accepted anytime.  These dues entitle each student to a full year of membership.

 

Student Name

Classification

Dues

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Student Name

Classification

Dues

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Return this form along with a check made payable to:
Texas Student Dietetic Association
2515 42nd Street
Lubbock, TX 79413