Individual Membership Application
AMNG
P.O. Box 94881
North Little Rock, AR 72190
| Last |
First |
MI |
(For
Office Use Only) |
NRA # |
| Street |
City |
State |
Zip |
| Home Phone ( ) - |
Home Fax ( ) - |
Home E-mail address |
| Work
Phone ( ) - |
Work
Fax ( ) - |
Work E-mail address |
* Check here ______ if this form is for change of address only *
MEMBERSHIP DESIRED
Please Check One
| TYPE OF MEMBERSHIP | FEE | PLEASE CHECK ONE |
| Annual Membership |
$20.00 |
|
| Associate Annual Membership |
$20.00 |
|
| Life Membership |
$150.00 |
|
| Associate Life Membership |
$200.00 |
|
| Honorary Membership |
NC |
MILITARY INFORMATION
Please Circle
| ANG | ARNG | Active Component | Non-Military | Retired Military |
MARKSMANSHIP ACTIVITY (OPTIONAL)
Please Check ALL that apply
| Distinguished Pistol | YES | President's 100 | YES | ||
| Distinguished Rifle | YES | Chief's 50 | YES | ||
| Distinguished International | YES | Other (Specify) | YES |
Signature ______________________________________
Date ________________
Please print, sign and mail with check or money order to:
AMNG, P.O. Box 94881, North Little Rock, AR 72190
