Return to the Membership Secretary:

NMSSA - Membership
Ken Laintz
P.O. Box 753
Los Alamos, NM 87544

NMSSA Annual Junior Membership(18 & Under)		$5.00		Three Year Annual Membership		$40.00
Senior Annual, age 65+		$12.00		Five Year Annual Membership		$65.00
One Year Annual Membership		$16.00		Senior Life Membership		$75.00
Annual Club Affiliation		$25.00		Life Membership		$150.00

Member Type: ___________________ Amount Enclosed: ________________

Name__________________________________________ Date of Application ________________

(Business Name)  ________________________________________________________________

Address________________________________________________________________________

City ___________________________________________   State________   Zip  ______________

Home Phone_____________________WorkPhone_________________Fax__________________

E-mail _________________________________________________________________________

We are considering sending the newsletter in a pdf version. Would you like to receive your bi-monthly newsletter pdf (email)? yes____      no _____

Are you an NRA Member?___________

Do you belong to a shooting club? _____  Name of club: ___________________________________

Please make check payable to: NMSSA

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