New York State
Muzzle-Loaders Association, Inc. Membership Application
[ ] Annual
Individual (18 years or older) $10.00
[ ] Annual
Affiliated Club Member $9.00
Club
Name_______________________________________
[ ] Annual
Family (parent(s) & children under 18) $17.00
[ ]
Individual Life Membership
$150.00
[ ] Annual
Club Affiliation
$25.00
Name
____________________________________ Date _________
Address
__________________________________
Town/City___________________________Zip_____________
Phone _______-___________ E-Mail_____________________
Signature
_________________________
Skills, Interests, Comments
______________________________________________________________
______________________________________________________________________________________
[ ] New
[ ] Renewal [ ] NYSMLA Affiliated
Send application
(photocopy OK) and membership dues (checks payable to
NYSMLA) to: NYSMLA Inc., 200 Clifford Drive, Vestal, NY
13850
