RANGELEY REGION GUIDES’ AND SPORTSMEN’S ASSOCIATION
P.O.BOX 244
RANGELEY, ME 04970
(207) 491-7711 OR (207) 864-5647
www.rangeleyguidesandsportsmen.org

Application for Membership

        _____ New application   or    _____Please renew and update my information
                                       
YOUR NAME: __________________________________   SPOUSES NAME: ___________________________  

CHILDREN’S NAME/S: _______________________________________________________________________


Phone Number: (     )_____________________________ 
                                
E-Mail: __________________________________________ 

Mailing Address: _____________________  City: ___________________ State: ______ Zip: _________

If seasonal resident:  
Local Address: ____________________________________  City: ____________________  Zip:_________ 

Local Phone Number: (     )________________  Dates in Local Area:_______________________________
                                                                                                                                                       
                                                                                                                                                   
Please check your Family’s interests in Sporting Events and/or Volunteer Service


Shotgun	        Hunter Safety Education     Casting for Recovery     Steak & Salmon Cookout (JUL)
Pistol	        Rifle Range	                Junior Guides	         Strawberry Festival (JUL)
Rifle	        Building & Grounds	        Live the Legend	         Sporting Shows
Black Powder    Construction Projects       Stream Restoration	     Youth Hunt Breakfast (OCT)
Archery	        Kitchen/Parties	            Club Fishing Pond	     Land Access
Fishing	        Grant Writing	            Fundraising		         Silent Auction
Yard Sale       Archery Course	            Outdoor Sporting Heritage Days (AUG)

MEMBERSHIP DUES 

___Individual-$20 ____Family-$30 ____Senior(70)-$10 ___Individual Life-$500 ___Family Life-$750

____Contributing-$50  ____Sustaining-$100     _____Sponsoring-$500      _____General Donation-$$


Payment Enclosed: $_______________ Thank You For Your Continued Support

Newsletter delivery options:  ____US Mail or_____I will view or print it from the RRGSA web site

Proof of membership: 		  All members will be mailed a RRGSA card as proof of membership. 
                                        
Club Pin or Decal: 		 ___yes ___no I would like a Club Pin    ___yes ___no I would like a Club Decal   
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Club Director’s Only: 
Payment Received: ______ (amount)    Date: ________ Received by: ______________________ (name)