COWBOY APPLICATION FOR MEMBERSHIP

Date of Application: ___________________

______ New Member Fees: _____ $35/year - Individual

______ Renewal _____ $60/year - Family (all members living in same household)

______ Reinstatement

COWBOY BADGE ORDER

Badge Fee: $60.00 each (includes Tax)

Engraving : Your SASS # __________ or letters under 6 characters __ __ __ __ __ __

We charge a $5.00 per badge postage fee if you want us to mail it to your home.

Applicant SASS # Shooting Alias: Name:

Primary __________ ____________________________ __________________________________

Spouse __________ ____________________________ __________________________________

Other __________ ____________________________ __________________________________

Other __________ ____________________________ __________________________________

Other __________ ____________________________ __________________________________

Other __________ ____________________________ __________________________________

Other __________ ____________________________ __________________________________

Address: _____________________________________________________________________________

City: __________________________________________ State: _____________ Zip: ____________

Home Phone: __________________________________________ Work Phone: __________________________

Email : __________________________________________

Send your completed form, along with your check made payable to The Cowboys to the following address:

THE COWBOYS

3843 So. Bristol Street,

PMB #: 284

Santa Ana, CA 92704

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THE COWBOYS USE ONLY:

Membership Card (circle one): Mailed Issued

Mailed/Issued by: ______________________

Paid by (circle one): Cash Check # __________

Amt Paid: ___________________

Renewal Date: ____________________

Data Entry: ____________________________________ Date Entered: _______________________________