NRA Application

National Rifle Association of America Membership Application Please fill out and mail this form to the address indicated at the bottom of the page.

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NRA Recruiter: Douglas Wannall

Recruiter ID: XR017114

Member Information:

___New Member ___Renewal NRA ID#(renewals only): __ __ __ __ __ __ __ __ __

Name:_______________________________________________________________

Address:____________________________________________________________

City/Prov:______________________________ State: _____ ZIP: ________ Country _________

Daytime phone: (____) _______________ Birthdate: ___/___/___ Today's Date: ___/___/___

Foreign members will be subject to additional postage charges. See 'Amount Due' section below.

Term/Type of Membership:

Adult (18 and over): ___1 year(~~$35~~ $25) ___2 year($60) ___3 year($85) ___5 year($125)

Junior (under 18): ___1 year w/Insights Newsletter($15) ___1 year w/Mag choice($24.95)

Distinguished (65+ or Disabled Veteran): ___1 year($30)

Easy Pay Life ($25 first month payment due immediately followed by quarterly payments of $25):
___ Regular (40 payments) ___ Junior (22 pmts) ___ Senior/Distinguished (15 pmts)

Life Membership: ___ Regular($750) ___ Junior($550) ___Senior/Distinguished*($375)

*Distinguished Life Membership is available for age 65+ or Disabled Veteran.

Magazine Choice: ___American Rifleman ___American Hunter ___America's First Freedom

Payment Amounts:

            Membership
Dues                                
$________
          

            Second Magazine
($15/year)                     
$________
          

            Foreign Postage (per year) Canada $5,
Other $10 $________
          

            Total
Amount                                   
$________
          

Membership dues paid to the National Rifle Association of America are not refundable or transferable and are not deductible as charitable contributions for Federal income tax purposes. Three dollars and seventy five cents of the membership dues are designated for magazine subscription.

Payment Information:

___ Check or Money Order (payable to National Rifle Association)

___ Charge to ___Mastercard ___Visa ___Discover ___American Express

Account #: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Exp. __ __/__ __

Signature (credit card only):_____________________________________

Mail application and payment to: National Rifle Association of America, Recruiting Programs Dept,
11250 Waples Mill Road, Fairfax VA 22030