NASSA "Shooting Stars" Membership/Match Application

 Print out this form, fill it out, and send it with
 your payment to the address listed below.

Personal Information

Name (Please print) ______________________________ Street address ______________________________ ______________________________ City, State, Zip ______________________________ Home phone number ______________________________ FAX number ______________________________ E-mail address ______________________________ Club affiliation (if applicable) ______________________________ NRA ID (if applicable) ______________________________ USA Shooting ID (if applicable) ______________________________ NASSA ID (if applicable) ______________________________ Venue (circle one) Rifle  /  Pistol Date of birth Month:___ Day:___ Year:___ Age: ___ Gun(s) Make: ______________ Model: _________________ Serial #: _______________________________ Make: ______________ Model: _________________ Serial #: _______________________________ Make: ______________ Model: _________________ Serial #: _______________________________

Postal Match Information

I want to participate in NASSA's, postal match program. (circle the price that applies) Date: _______________ PayPal: _____________ Check #: ____________ Not necessary to be a NASSA member to compete in NASSA's Postal's. However, it is encouraged. # Months* P1 Awards Only P2 Awards Critique 1 $10.00 $15.00 3 $30.00 $45.00 6 $60.00 $90.00 12 $120.00 $180.00 *NASSA members: save $3.00 every three months when you pay ahead for 3, 6, or 12 months!

Membership Information

Annual FISCAL dues are from October - September of any given year.  Example Oct-08 - Sept-09. NOTE: If you join NASSA in March or after, your annual dues are reduced 1/2. NOTE: DPC dues are included and not seperated. Date: _____________ PayPal: ____________Check #: __________ Annual (new members): $125.00 US Family: $175.00 US Life: $500.00 US Referred by ______________________________ NASSA ID of referring member ______________________________

Make checks payable (in U.S. funds) to E. C. Wong (Pistol Account), and mail completed form with payment to: NASSA / Membership & Statistical Office / 2103 Wheaton Drive / Richardson, TX 75081