National Association of Shooting Sports Athletes
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Morini CM84E Free Pistol


Morini 162EI Air Pistol




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


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