NAME:________________________________________________________________
 

ADDRESS:______________________________________________________________

CITY:_______________________________ STATE:_______________ ZIP _________
 

E-MAIL ADDRESS:_____________________________________________________
 

TELEPHONE #: (H)__________________________

SASS #:____________________________

SASS ALIAS:_____________________________________

NRA#:____________________________

Please list any talents, or abilities you have that you would be willing to use for the benefit to the club:

__________________________________________________________

__________________________________________________________

Which of the following committees would you like to assist with?: _____ Range Officer _____

Shooting Instruction _____ Site Construction _____ Membership _____

Shooting Stage Design _____ Target/Prop Construction

Please complete this form and enclose your check or USPS money order for $25.00, add $20.00 for family membership, includes only spouse and children under the age of 21 living at home or fulltime college students..

Payable to: ___________________________________________
 

West Plains Waddies
8406 C.R. 8970
West Plains, MO. 65775

Call 417-255-1194
Ask for Branding Irons