Renewal Form June 1, 2010 thru June 1, 2011
	Mail To:						Memb #
	Niagara County Sportsmen's Association Inc.						Amount.
	P.O. Box 194						Check #
	No. Tonawanda, New York 14120-0194						Date	/      /
							IR Paid
	May 1, 2010
	Dear Fellow  Member,
	Our 2010-11 dues are due June 1st.  Please complete this form, enclose a
	check or money order for the appropriate amount and return it to the address above.
	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 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)……………………						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)
	(You must be eligible to use this range)……………………………….						$20.00
	This option can be activated at any time during the year
	but will only be activated for eligible members.						Total  $
	If you have any Question, Please email me at  MikeBart@NCSAonline.org
	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 #