________________ — Membership Application
Thank you for your interest in ________________ for the ________________ season. Annual dues are ________________ dollars. Please complete this form and return it to ________________. Membership is approved by vote of the members.
Applicant information
Full name: __________________________________________
Address: __________________________________________
City / State / ZIP: __________________________________________
Phone: ____________________ Email: ____________________
Date of birth: ____________________
Hunting experience
Years hunting: ________ Species hunted: __________________________________________
Hunting license number and state: __________________________________________
Hunter education certificate number (if required): __________________________________________
Previous clubs or leases and how long: __________________________________________
Have you ever been convicted of a game law violation? Yes / No. If yes, explain: __________________________________________
Vehicle
Vehicle(s) you will drive on the property (make, model, color, plate): __________________________________________
Emergency contact
Name, relationship, and phone: __________________________________________
References
Current member who referred you (if any): __________________________________________
Other reference and phone: __________________________________________
Agreement
If accepted, I agree to pay dues on time, follow the club rules and bylaws, sign the club liability waiver, take part in work days, and respect the landowner and the property. The information on this form is true.
For club use
Date received: ____________ Approved / Declined Vote date: ____________ Dues paid: ____________