COSSA

CENTRAL OREGON SHOOTING SPORTS ASSOC.

MEMBERSHIP APPLICATION

General membership is open to any person 18 years or older. Family memberships are available with a privileges extended to the immediate family, living at the same address. Adults must supervise children under the age of 18. To continue to improve the range we need your help. You will be asked to volunteer time to assist on projects. You will receive a credit towards your next year's dues at the rate of $8 per hour for time worked. Also, you will receive a $5 referral credit for each new member you sponsor. In short, you can offset the entire cost of the next year's dues. These credits shall not exceed the amount of the next year's dues and is not cumulative to succeeding years. The annual dues for a new individual membership is $75 and $100 for a family membership. For more information call Mark Fero @ 541-548-5566

Please print full application and fill out. We require the full application. If full application is not received we will require a new application.

                                                            Member Information:

Name____________________________________________________________ Date______________________

Address______________________________________________________________________________________

City___________________________________________ State_____________ Zip________________________

Phone_________________________________________ Date of Birth __________________________________

E-mail_______________________________________________________________________________________

NRA Member Yes___________ No_____________ Member Number___________________________________

SPONSOR____________________________________________________________________________________

Family Members:

Name________________________________________________________ Age____________________________

Name________________________________________________________ Age____________________________

Name________________________________________________________ Age____________________________

Mail to: COSSA                                                                                          Meetings at Bend VFW Hall

             P.O. Box 1606                                                                                4th St. and Olney Ave. @ 7PM

             Bend, Oregon 97709                                                                       2nd Thursday of the month

Membership requires all shooters to follow Fundamental Gun Safety Rules. Infractions of rules and regulations can lead to expulsion. Submitting this application for membership indicates agreement these terms.

Signature: ________________________________       Date: __________________________________________

Paid ---- Cash __________ Check No _____________ By ______________________   Renewal -- Yes _____ No ______

rev 4/13/2012web