I Want YOU to Join Now

Join Now



This form is provided so that you may submit your application online.  You will then be contacted.

If you prefer to fill in a printed form and mail it, please click on the following link.  The mailing address is at the bottom of the form.

Download Membership Application

Note the annual dues:
$100 for a large club
$ 50 for a small club

 

Club Name:
Individual Name:
Mailing Address:
City:
State:
Postal Code:
UPCA Representative:
Telephone:
Fax:
Email:
Year Club Started:
Meeting Day/Time:
Meeting Location:
Active Members: 1-10
11-20
21-30
31-40
41-50
Over 50
Pipe Related Events: Yes
No
Event Descriptions: