Please PRINT OUT This Application Form, Fill It Out, and Mail It To The Address Below

NRA MEMBERSHIP APPLICATION

Application Type: ___Annual Member @ $25     ___Liberty Member @ $10

___Junior Member @ $15 (Under Age 21, Includes "Insights" Magazine)

NAME: ___________________________________ If Renewal, Give NRA ID #: __________

MAILING ADDRESS: _____________________________________________ APT #: ______

CITY: ___________________________________________ STATE: _______ ZIP: _________

BIRTHDATE: ______________ WORK TEL: ______________ HOME TEL: ______________

If You're Applying For Annual Membership, Choose One Magazine:

___American Rifleman ___First Freedom ___American Hunter

NOTE: Liberty Membership Does Not Include A Magazine

Payment Method: ___Check or Money Order Enclosed ___Credit Card

NOTE: Check or Money Order Should Be Made Payable To: "NRA"

If Paying By Credit Card, Please Provide The Following Information:

NAME ON CREDIT CARD: _______________________________ TYPE OF CARD: ______

ACCOUNT #: ___________________________________________ EXP DATE: __________

SIGNATURE: ________________________________________________________________

Please Mail This Completed Application Along With The Appropriate Payment To:

Jeff Weinstein, NRA Recruiter

PO Box 373

Yarmouth ME 04096

Please Allow Approximately Four Weeks For Processing

Thanks!

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