Membership Application / Renewal Form

The dues for the year_ 2010______ are now being collected.

$60.00              New Member
$40.00              for membership dues paid before December 31.
$45.00              for membership dues paid after December 31.
$ 15.00              for Senior citizens (age 62 or older) paid before December 31.
$20.00              for Senior citizens (age 62 or older) paid after December 31.

NEW MEMBERSHIP FEE INCLUDES A $20.00 FIRST YEAR INITIATION FEE.

Please complete the following information for our membership database. Keep in mind, your membership
covers everyone in your immediate family under the age of 16 years old. Children over the age of 16 must
have their own membership but are not required to pay the initiation fee.

NAME:______________________________         SPOUSE______________________________

                                                                   Additional cards for family members under age 16:

ADDRESS:___________________________           NAME:_____________________ AGE:_______
CITY:_______________________________           NAME:____________________AGE:_______
STATE:_____________________________            NAME:____________________ AGE:_______
ZIP:_________________________________          NAME:____________________ AGE:_______
PHONE:______________________________          NAME:____________________ AGE:_______
LICENSE PLATE:_______________________
E-MAIL ADDRESS:

New members please circle following area of interest:
Hunting            Fishing           Archery            Rifle Range              Shotguns (clay shooting)
Sponsors (please list 2)___________________________________________

TO HELP KEEP THE CLUB'S EXPENSES TO A MINIMUM. TO RECEIVE YOUR 
NEW MEMBERSHIP CARDS PLEASE ENCLOSE A SELF ADDRESSED STAMPED
ENVELOPE OR PICK UP YOUR CARDS AT ANY CLUB MEETING. MEETINGS ARE 

HELD THE
2ND MONDAY OF EACH MONTH.

Please return this form, SASE and a check made payable to Frontier Archery Club to:

Frontier Archery Club                               We plan to use E-mail to communicate with our
c/o Allen Leets Jr.                                    members rather than postal mail. Between meetings.,
361 Rosecliff Drive                                   please check out the club's website at:
Douglassville, PA 19518                           
www.frontierarcherv.com.

FOR OFFICAL USE ONLY BELOW THIS LINE_____________________________________ .

FIRST READING________________________
SECOND READING______________________
MEMBERSHIP CARDS SENT_____________