BARTLESVILLE SPORTSMEN'S CLUB, INC. - (Club)

P.O. Box 391 - Bartlesville, OK 74005-0391

 
NEW MEMBERSHIP APPLICATION
Last Name: ________________________  First Name: ___________  Initial: ____
Date of Birth: _____________  Street or P.O. Box: _________________________ 
City: ___________________________  State: ________________  Zip: ___________ 
Home Phone: ___________  Other Phone: ___________
Email: _________________________________________________________________
Monthly Newsletters are available on the BSC Website (http:\\bartlesvilesportsmensclub.org)
Do you want a newsletter mailed?   (Y)   (N)
Are you available to help in emergency situations (flooding etc.)?
Call me at: Home ( ) Other ( )
Note: All new members must pay a Lifetime Initiation Fee of $50.00 to the Bartlesville Sportsmen's Club.
Half-Year dues are available for NEW MEMBERS ONLY!
*Associate Member: The spouse of a regular member and a regular member's dependents who are over 18 years of age, but under 21 years of age may become Associate Members of the Club, but MAY NOT vote on club business.
**Junior Member: Regular member's dependents who are under 18 years of age and MUST be supervised on the firing range by a Regular Member at ALL TIMES. Junior Members MAY NOT vote on Club business.
   
Regular Membership ($50 annual fee + $50 Lifetime Initiation Fee)

$100

*Family Membership ($25 annual fee)

$25

Associate Name: _________________________________________________
Junior Name: ____________________________________________________
Junior Name: ____________________________________________________
Junior Name: ____________________________________________________
Junior Name: ____________________________________________________
Note: Membership Total:
Individual= $100; Family= $125
AMOUNT ENCLOSED $_____________
 
PLEASE NUMBER THE CLUB ACTIVITIES BELOW IN THE ORDER OF YOUR INTEREST:
(___)Skeet (___)Trap (___)Pistol (___)Rifle (___)Bench Rest Rifle (___)Archery (___)Sporting Clays(___) I am willing to help with Club activities. Call me at Home (___) Work (___).


I certify that I will actively promote wildlife conservation and comply with all the rules and regulations of this Club. I will observe and obey all laws of the Oklahoma Department of Wildlife Conservation. It is further understood that in the event my hunting or fishing license should be suspended membership in this Club may also be suspended with NO REFUND of my membership dues or fees.

Date: _____________

Applicant's Signature:  __________________________________________________
Sportsmen's Club Member Sponsor:  ____________________________________