2017CardNumber:FullName:StreetAddress:City: State: Zip: -Phone: Email: @LicensePlate#:
PresentOccupation:Retired? YESNO AllNRAMember? YESNO LakeVeteran? YESNO YESNO RangeBirthDate: Ifsoinwhatarea:
ArcheryYouth
Other
NLFGCPOBOX41
N.LAWRENCE,OH44666-0041
MEMBERSIGNATURE: DATE:
SPOUSESIGNATURE: DATE:
Newfor2018:RECEIVEADISCOUNTONYOURRENEWALFEES.FOREVERYNEWMEMBERTHATYOUREFERTONLFGANDBECOMESAN
OFFICIALMEMBERYOUWILLRECEIVE25%OFF.FORMOREINFORMATIONCONTACTTHEOFFICEAT:[email protected]
DuesincreaseapprovedNov.2016effectiveApril1st,2017
BysigningtheaboveformyouverifythatyouagreewiththeRangeSafetyRulesandyourformwillbekeptonfileatNLFG
Ifyouwouldliketoreceiveyour2018MembershipCardinthemailpleasesendaselfaddressedstampedenvelopealongwithyourRenewalformanddues
Spouse:
CREDITCARDSACCEPTEDATANADDITIONAL3%SERVICECHARGE
Regular:$232.00includingSalesTaxSenior:$126.00includingSalesTax
IfpaidApril1storlater($20latefee):
NLFGMembershipRenewalForm
PLEASEREMITPAYMENTANDRENEWALFORMTO:MAKECHECKPAYABLETO:
NLFGC
Regular:$212.00includingSalesTaxSenior:$106.00includingSalesTax
TobepaidpriortoApril1st:
ContactInformation
ClubInterests
ShotgunSports
Areyouwillingtohelpwithmaintenance?
OtherInformation
YouqualifyforSeniorMembershipif62asofJanuary1,2018
MembershipRates
