United Shoe Retailers Association
Join us
United Shoe Retailers Association
A Non-Profit Organization dedicated to serving Independent Shoe Retailers nationwide
Initial Membership Application Form
Your Company Name:
Website:
Mr
Mrs
Ms
First Name:
Last Name:
Address:
City /State /Zip:
Phone:
Fax:
Email:
Your Job Title:
Owner
President
Vice President
Store Manager
General/District Manager
Buyer
Merchandise Manager
Other, please specify:
MEMBERSHIP $95
per Membership Year -- Membership year 10/1-9/30

Total:
Method of Payment:
Check payable to: USRA
Mail check payment to:
USRA Membership Dept
PO Box 4931
West Hills, CA  91308
PayPal
Mastercard
Visa
Credit Card #:
Expiration Date:
Recurring Billing – 30 Day Notice
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