IVRPA MEMBERSHIP APPLICATION

 

CIRCLE ONE -- ANNUAL-$35.00.................................JUNIOR-$10.00..............................................LIFE-$350.00

CIRCLE ONE -------- NEW MEMBERSHIP..........................RENEWAL OF MEMBERSHIP

 

IMPERIAL VALLEY RIFLE AND PISTOL ASSOCIATION, Inc.

P.O. BOX 241, IMPERIAL, CALIFORNIA 92251-0241 US

 

 

NAME (print):  __________________________________________________________________________________

                           (LAST,)                                           (FIRST)                                          (MIDDLE)               (SUFFIX)

 

ADDRESS:  ____________________________________________________________________________________

                     (CITY,)                                                           (STATE)              (ZIP+4 preferred: http://zip4.usps.com)

 

 

TELEPHONE NUMBER(S):  _______________________________________________________________________

 

 

E-MAIL ADDRESS: ______________________________________________________  AGE: __________________

 

 

N.R.A. MEMBER # ______________ PROFESSION: ___________________________________________________

 

 

HOBBIES:  _____________________________________________________________________________________

 

 

OTHER CLUB AFFILIATIONS: ______________________________________________________________________

 

As a member of the IVRPA, Inc., I agree to abide by the rules and regualtions and to support my club to the best of my ability and complete two mandatory days of range duty and/or work parties per year.

 

 

SIGNATURE: ____________________________________________________________________________________

 

 

RECOMMENDED BY:  _____________________________________________________________________________

 

(The selection below to be completed by IVRPA officers/members)

 

 

GENERAL MEMBERSHIP APPROVAL: _____________ DENIAL: ________________  DATE:___________________

 

 

Please bring this application with appropriate fees to the IVRPA monthly meeting at 7:00 p.m. on the 1st Tuesday of each month.  The meeting is held at Dion International Trucks, 397 East Evan Hewes Highway, El Centro, Ca 92243-9707.  For information call Ken Claverie at (760) 357-4006 or e-mail kenval@thegrid.net or Jerry McDonald at (760) 427-0051.  Additional IVRPA information, maps, range schedule, events and contacts can be found on the IVRPA website at http://ivrpa.net

 

---------------------------------------------------------------------------------------------------------------------------------------------------------------

Optional space for notes, additional comments: