Dubuque Field Archers 
MEMBERSHIP APPLICATION



CASH-CHECK-MONEY ORDER________________________ TOTAL AMOUNT  $___________


Name: _____________________________________        Date: _________________

Address: _________________________________________________        

City: ________________________   State: _____________  Zip: ________________




LIST ALL FAMILY MEMBER�S NAMES BELOW


(Add birth date if member is under 18 years of age)



     2nd Family Member    ________________________________Birth date_______

     3rd Family Member    ________________________________Birth date_______

     4th Family Member    ________________________________Birth date_______

    




MEMBERSHIP FEES


    Single Membership  --------------$45.00 
    Single Youth ( 12-17 yrs.)-------$20.00  
    Family --------------------------$50.00



Make check payable to the " Dubuque Field Archers "


                           MAIL TO:          Joe Tilp
                                             1210 Madera Street
                                             Dubuque, IA   52001-0518





Hosted by www.Geocities.ws





        








1