________________________________________________________________
ADDRESS ______________________________________________________
______________________________________________________
CITY ___________________ STATE _________ ZIP_________________
COUNTY________________
PHONE # ( )_________________________ eMail _______________________________________
I Wish To Receive GUNSMOKE by Mail_______ By eMail Electronically_________
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)
______ GOLD LIFE MEMBERSHIP- New $1300.00; Upgrade from Current Life- $900.00
______SILVER LIFE MEMBERSHIP- New $1050.00; Upgrade from Current Life- $650.00
______BRONZE LIFE MEMBERSHIP- New $800.00; Upgrade from Current Life- $400.00
TOTAL ENCLOSED $___________
_____ASSOCIATE, Spouse of Life/Annual Member $12.00/Yr
_____3 Yr. $30.00 LIFE $200.00 COND. (5X$42.00)
_____CLUBS/LEAGUES $25.00/Yr $60.00 3/Yr
LEGISLATIVE DONATION $ __________
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Ohio Rifle and Pistol Association
P.O. Box 43083
Cincinnati, Ohio
45243-0083...
