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GOAL APPLICATION
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Gun Owners' Action League
PO Box 567
Northboro MA 01532
FAX: (508) 393-5222
MEMBERSHIP APPLICATION
________________________________ _______________________________
Last Name First Name
_________________________________________________________________
Mailing Address
_________________________________________ _______ _____________
City State Zip
________________________________ _______________________________
Home Phone Work Phone
___________________________________________________ ____________
Occupation Date
To what local sportsmen's clubs do you belong?
Are you an NRA member? ( ) Annual ( ) Life ( ) No
CIRCLE
JUNIOR (under 18; birthdate: _________) 1 year $ 10 ______
INDIVIDUAL 1 year $ 25
3 years $ 65
5 years $ 100 ______
Sustaining Life* $ 400 ______
Benefactor Life* $ 650 ______
Patron Life* $1200 ______
FAMILY 1 year $ 30
(Provide names of family members 3 years $ 80
to receive cards on line below.) 5 years $ 125 ______
_________________________________________________________________
*For a personal payment schedule, please contact the GOAL office
at 508-393-5333.
Enclosed is ( ) Cash ( ) Check or Money Order
or Bill my ( ) Master Card ( ) Visa
Card #: ___________________________________ Expiration: ________
Signature: ______________________________________________________
Note: $5.40 of your membership dues pays for a subscription to
GOAL's monthly newspaper, The Message. |
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