|Established 1942 NRA # CO 285
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
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____
|Applicant’s Signature: _______________________________________ Date: ____/____/ ____
|Sec. Rec’d App. - ____/____/____ HCCC Membership approved? ____/____/____
|Treas. Rec’d. Dues - ____/____/____ Amount = $______ Cash/ Check# _________
Card given / sent - ____/____/ Renewal Date ___________Member Since: ____________