Membership

Wellsville Rod and Gun Club

PO Box 53

Wellsville, NY  14895

NAME:_______________________                Membership year ______(1/1-12/31)

Address:_____________________________________________________

Phone:________________________

Email:_______________________

Signature:____________________________  Date: _________________

New Member Sponsor or Reference _______________________________

Members must be US Citizens and legally able to own firearms

Fees:  Individual member $25.oo ___    Family member $60.00 ____

Junior member (under 16) $10.00 ___

Lifetime member $250.00 ___

Copy and paste this form.  Fill out and return to above address with check for dues. Thank you for joining us!