Hillsdale Rifle Club
Established  1942                                                                                                                       NRA # CO 285
P.O. Box 87 Osseo, MI    WWW.hillsdalerifleclub.com
Membership Application
The Hillsdale Rifle Club Offers Several Additional Membership Privileges beyond those of the Hillsdale County Conservation Club,
of which every HRC Applicant must also be a Member. HRC Members gain access to the range and pistol houses,  equipment and
target stands, discounted fees to participate in some events and the opportunity to make surplus purchases through the Civilian
Marksmanship Program.
Please fill in all applicable information on this Membership Application, even if your just renewing, and either return it to the HRC
representative from whom you obtained it or send it to HRC Secretary John Gertig 5240 E. Reading Rd, Osseo 49266.
* MUST BE FILLED OUT COMPLETELY  PLEASE PTINT!
* Last Name: __________________ *First Name__________________*M.I.___   Spouse: __________________
* Driver’s License # ____________________________ * Date of Birth: M ___ D __ Yr. ____ NRA# _________________
* Street Address: _____________________________________________________________________________________________
* City, State & zip code: _____________________________________________________
* Phone: ________________________      E-Mail: ___________________________________
   Type of Membership: _____ - Regular: $24/year  ______ - Senior (65 & up): $12/year
Dues are prorated on a monthly basis to/from June 1st of each year. Senior rate is ½ regular.
Jan $10- Feb $8- Mar $6- Apr $4- May $2- Jun $24- Jul $22- Aug $20- Sep $18- Oct $16- Nov $14- Dec $12
I am interested in (or would volunteer for):  ARA____ Service Rifle____ Varmint Shoot____  Egg Shoot____ 3-Gun Combat____
Bowling Pin____ Bull’s-eye Pistol____ Precision Handgun____ Hunter Safety Classes____ Range Maintenance____
Other: _________________________________________________________________
Applicant’s Signature: _______________________________________                                 Date: ____/____/ ____
OFFICAL USE ONLY
Sec. Rec’d App. - ____/____/____         HCCC Membership approved? ____/____/____
Treas. Rec’d. Dues - ____/____/____       Amount = $______    Cash/ Check# _________
  Card given / sent - ____/____/   Renewal Date ___________Member Since: ____________