eMembership Form e-Membership Form Join or renew membership to PHBA Step 1 of 4 - Membership Type 0% What would you like to do today?* New Membership Renewal Membership Adding to an existing open membership If you already have a current Open or Lifetime Open membership, please select "Adding to an existing membership".PHBA Member ID You have chosen to renew or add to an existing membership, so you must provide your PHBA member number.Membership Type(s):* Open Joint Open Lifetime Open Amateur Youth Lifetime Youth Choose all that apply. *Lifetime Open - is individual only *Lifetime Youth - Ends at age 19, but allows for a discount conversion to Open Lifetime. Please contact the PHBA office for Youth Lifetime Conversion options.Amateur* Amateur Novice Amateur Amateur Select Choose Amateur, Novice Amateur or Amateur SelectYouth* Youth Novice Youth Choose Youth or Novice Youth Birth Date:* MM slash DD slash YYYY Name First Last Membership Name* Enter the full name as it should appear on the membership. This could be a couple : Sue/Joe Smith Or it could be a farm or business: Still Water Farms, LLCAddress* Street Address City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Phone*Alternate PhoneEmail* Enter Email Confirm Email Would you like a Copy of the PHBA Handbook sent to you?* Yes No Handling OptionsSingle Open Price: Joint Open Price: Lifetime Open Price: Lifetime Open Membership entitles you to all member benefits for a one-time fee.Amateur Price: Amateur or Novice Amateur added onto an open membership.Youth Price: Rush Fee:* No Rush 2 Week Rush +$25.00 72 Hour Rush +$50.00 2 Weeks Prior to or During World Show +$100.00 Shipping* Regular USPS Overnight +$25.00 UPS Overnight +$45.00 Fed-Ex Overnight +$50.00 Credit Card Handling Fee* Price: I would like to donate this amount to the Youth Scholarship Fund. I would like to donate this amount to the PHBA Heritage Foundation. Total $0.00 CAPTCHAEmailThis field is for validation purposes and should be left unchanged.
