POTTAWATTAMIE BOWHUNTERS

P.O. Box 344

COUNCIL BLUFFS, IA 51502

MEMBERSHIP APPLICATION

PLEASE PRINT OUT THIS FORM

COMPLETE FORM IN INK

AND MAIL TO ABOVE ADDRESS,

TURN IN AT BOWSHOOT

OR TURN IN TO MEMBER

ANNUAL DUES PAYABLE JULY 1st^st EACH YEAR

DUES EXPIRE JUNE 30th^th EACH YEAR

NAME:__________________________________________________________________

ADDRESS:_______________________________________________________________

CITY:__________________________ STATE:______________ ZIP:_________________

E-MAIL ADDRESS:________________________________________________________

TELEPHONE:_____________________________________________________________

FAMILY MEMBER NAMES:

SPOUSE:_________________________________________________________________

CHILDERN:_______________________________________________________________

ARCHERY AREA OF INTEREST______________________________________________

I REQUEST TO BECOME A MEMBER OF THE POTTAWATTAMIE BOWHUNTERS ARCHERY CLUB. I AGREE TO SUPPORT THE CLUB TO THE BEST OF MY ABILITIES, TO ADVANCE THE SPORT OF ARCHERY AND BOWHUNTING, AND TO PROMOTE GOOD SPORTSMANSHIP.

TYPE MEMBERSHIP:

SINGLE: $30.00________

FAMILY: $40.00________

YOUTH : $20.00________ Under 17 Years

SIGNATURE:___________________________________

DATE:_________________________________________