This form is made to be printed out for your
convenience:
Name:_________________________________________________Phone#:(_____)
_____-_________
Address:___________________________________________________________________________
City:
____________________________________________________State:________Zip:__________
Email:
_______________________________________
Is this a renewal? Yes____ No
____
Are you a member of the IBS? Yes____ No ____
Are you a member
of the NRA? Yes____ No ____ Member ID: _______________
Are you a member
of the Virginia State Shooters Assoc.(VSSA)? Yes____ No
____
Signature:
_________________________________________________
Club Dues •
$40 - 1 yr. Virginia 1,000yd Benchrest Club Membership before March 15th,
2008
• $45 - 1 yr. Virginia 1,000yd Benchrest Club Membership after
March 15th, 2008
• $25 - 1 yr. Junior Virginia 1,000yd Benchrest Club Membership
(<=18yrs)
• $40 - 1 yr. Family Membership. $20/yr for each
additional family member
• $400 - 1 yr. 10 match / 2 gun + membership pre-pay. Before March
15th, 2008
• $220 - 1 yr. 10 match / 1 gun + membership pre-pay. Before March 15th, 2008
Make your check out to: VA 1000 Benchrest
Club
Mail To:
Virginia 1000YD Benchrest
Club