________________________________________________________________
ADDRESS ______________________________________________________
______________________________________________________
CITY ___________________ STATE _________ ZIP_________________
COUNTY________________
PHONE # ( )_______________
TYPE OF MEMBERSHIP (Check one)
JUNIOR (Individual)........................................$8.00/Yr --Date of Birth______/______/_____
RENEWAL_________ NEW________________
ANNUAL (Individual)...................................... $25.00/Yr
TOTAL MEMBERSHIPS $
________________
_____3 Yr $65.00 ______5 Yr $105.00
_____LIFE (Individual) ......................................... $400.00
______ SENIOR LIFE (Age 60 & Over)..................... $240.00
_____CONDITIONAL LIFE (Individual) .................. $410.00
(Five payments of $82.00)
______ CONDITIONAL SENIOR LIFE ........................ $250.00
(Five Payments of $50.00)
TOTAL ENCLOSED
$___________
_____ASSOCIATE, Spouse of Life/Annual Member $9.00/Yr
_____3 Yr. $25.00 LIFE $150.00 COND. (5X$32.00)
_____CLUBS/LEAGUES $25.00/Yr $60.00 3/Yr
LEGISLATIVE DONATION
$ __________
MAKE CHECKS PAYABLE TO AND MAIL TO:
Ohio Rifle and Pistol Association
P.O. Box 43083
Cincinnati, Ohio
45243-0083...
