508-987-8783
Print, fill out and return to the club in care of Membership Director
Name (Last, First, Middle): Address : City, State, Zip : , Email address : Date of Birth : Phone number :
Check all that apply: F.I.D. Card License To Carry N.R.A. membership Goal Membership
Sponsor (you must have one member of Singletary Rod & Gun that is in good standing to be considered for membership)
Name : Membership Number: Signature :
Signature: Date: