Membership Application

U-SSA National Council | Membership Application | Patron of the Society

Please print off this page and mail to the address provided at the bottom of this form.

Check membership category:

Individual: _____

Family: _____ (List spouse's name also)

New Member: _____

Renewal: _____

Annual membership dues: Individual: $15, Family: $20 (upon the initial dues payment, dues are payable in January of each year)

EMAIL: _______________________________________________________

TELEPHONE: ___________________________________________________

FULL NAME: ___________________________________________________

COMPLETE ADDRESS: ____________________________________________



I am interested in volunteering for the following committees and activities:

Membership _____

Publicity _____

Newsletter _____

Special Events _____

Social Activities _____

Web Page _____

Education _____

Historian _____

Area Convener _____

Note: Completed applications and attached dues payments can be mailed to:

Ulster-Scots Society of America
Attn: Glen Pratt
P.O. Box 3969
Amarillo, TX 79116

For more information contact Glen Pratt (President) at email:



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