NRA #: _______________________________ASRPA exp date:______________________
Last Name: ___________________________ First Name: __________________________
Street Address: _____________________________________________________________
City: _______________________________________ State: _________ Zip: ___________
Day Phone: __________________________ Eve Phone
:___________________________
email address:
________________________________________________________________________
Please circle the appropriate choice below:
| All individual matches Fri, Sat, Sun | Adults | $70.00 | |
| All individual matches Fri, Sat, Sun | Jr & Sr. | $60.00 | |
| All individual matches Sat, Sun | Adults | $60.00 | |
| All individual matches Sat, Sun | Jr & Sr. | $50.00 | |
| One Day Only | Adults | $35.00 | |
| One Day Only | Jr & Sr. | $30.00 | |
| Team Match ( pay at range) | All | $40.00 | |
| ASR&PA membership Dues | Adults | $20.00 | |
| ASR&PA membership Dues | Jr |
$5.00 | |
| Single Match ASRPA Membership Fee | All | $5.00 | |
| Total fees enclosed: |
Mail to:
Middleton Tompkins
P.O. 11684
Prescott, AZ 86304
Make additional copies if needed.
Printed from http://arizona.rifleshooting.com/
web site, comments to bill@poole.com
Oct-08