NEW MEMBER APPLICATION
Name____________________________________________ Date_____________________
Address_________________________________________ City_____________________
State_______ Zip____________
Age_________  Occupation__________________________________________________
Phone Number_______________ Email_________________________________________
Have you ever been convicted of a felony, crime, or misdemeanor?__________
If so, state place, date and nature of crime______________________________
Have you ever had a concealed weapon permit cancelled?__________
If so why?________________________________________________________________

   Applicant's Signature___________________________________________
   One Member's Signature__________________________________________
   Approved by_____________________________________________________
              Chm of Membership Committee
==========================================================================
COST OF MEMBERSHIP - JUNIORS (age 12 to 17) $15 & $1 INITIATION FEE
                     REGULAR (age 18-64) $70 & $20 INITIATION FEE
                     KEYS ARE AVAILABLE TO REGULAR MEMBERS $5

YOU MUST ATTEND A MEETING TO APPLY AND BE ACCEPTED INTO MEMBERSHIP.  AT WHICH TIME YOU WILL GO OVER THE RULES BEFORE APPLICATION CAN BE APPROVED.  DUES ARE DUE AT THAT TIME, MEMBERSHIP CARD AND KEY WILL BE ISSUED.

MEETINGS ARE HELD THE 2nd WEDNESDAY OF THE MONTH

Received of_______________________________  Date_____________
Subject to the approval of the Association.
If not approved this money will be returned.
$_________________   Check #__________  Cash________

(Mark One)____Regular Member    ____Junior Member
If you do not receive your official membership card within 30 days, notify your secretary
By_________________________________________
   ______Card sent  _______Key Provided

Please visit our website:  www.pineriversportsmans.com for updated information on club activities, calendars, pictures and upcoming events.