Niagara County Sportsmen's Association's
	Online Renewal Form - June 1, 2011 thru June 1, 2012
	Mail To:					Member Number
	Niagara County Sportsmen's Association Inc.					Check Amount
	P.O. Box 194					Check Number
	No. Tonawanda, New York 14120-0194					Date of Check		/      /
						Indoor Range Paid
	May 1, 2011
	Dear Fellow  Member,
	Our 2011-12 dues are due June 1st.  Please complete this form, enclose a check or money order
	for the appropriate amount, and return it in the enclosed envelope.
	Your cancelled check serves as your payment receipt. No Cash Please
	This form should be mailed to the above address, or placed in the drop box next to the
	sign in sheet at the club. Please allow up to 8 weeks to process your payment.
	Please do not leave your dues with caretaker, it is not his responsibility to accept your dues.
	Please use the following schedule to determine the proper amount to enclose:
	1. Life members (please return with any address change)……………………						N/A	$0.00
	2. Membership (Standard)………………………………………………….						$  75.00
	3. Membership (with at Least 10 Work Hours) …………....………...……..						$  55.00
	4. Senior membership (64 yrs old and 5 years continuous membership.						$  37.50
	With Work Hours…………………………………………………..						$  27.50
	5. Junior membership (16, 17 or 18 years old)……………………………..						$    3.00
	6. Additional indoor range fee (optional)						$  20.00
							Total	$
	If you have any Question, Please email me at  MBart0091@aol.com
	Please refer to "NCSA Renewal" in the subject line, or call 695-0090 and leave a message.
	Thank you for your continued support.      Mike Bartlett
	Name_______________________________________________
	Membership #____________ Amount enclosed $ ____________
	*************** Please Indicate Address Changes Only ***************
	New Address	__________________________________________________
	New City	__________________________________________________
	New State				New Zip	_______-______
	New Phone #