SASS ALIAS: _____________________________________________________________
SASS NO: _______________________________ NRA NO: _______________________
SASS LIFE MEMBER: Yes _____ No _____ NRA LIFE MEMBER: Yes _____ No _____
CITY: ________________________ STATE: ___________ ZIP CODE: ______________
EMAIL ADDRESS: _______________________________________________________
TELEPHONE: (H) _________________________ (W) ___________________________
National Rifle Association Pledge: I certify that
I am a citizen of the United States of America and that I am
not a member of any organization or group which has as any of its programs the attempt to overthrow the
government of the United States or any of its political sub-divisions by force or violence, and if admitted to
membership I will faithfully endeavor to fulfill the obligations of good sportsmanship and good citizenship.
SIGNATURE __________________________________________ DATE _____________
Please list any particular talents, interests or abilities you
have that may be of interest to The
River Junction Shootist Society.
With which of the following committees would you like to work?
Range Officer _________
Target/Prop Construction _________
Shooting Stage Design _________
Match Results _________
Dues are $35/year per member. Family rate is $55 andincludes family members
residing at the same address.
Make check payable to River Junction Shootist Society
and send with completed application to the following address:
RIVER JUNCTION SHOOTIST SOCIETY
P.O. BOX 185
DONEGAL, PA 15628