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Middleboro Sportsmenís Club  P.O. Box 633  Middleboro, MA  02346 Phone: (508) 947-9670
Applicant Must hold valid Ma. LTC and NRA membership
HIS MUST BE PRESENTED IN PERSON at a regular meeting.



DATE:             ______                            _____                                   Ma FIREARMS PERMIT#:  ____                       _____________


Name:                                                                                  NRA Membership#:                                         

Address:                                                                               Day Time Phone#: (          )                                      

City/Town:                                                                            Email Address:                                                

Zip Code:                                                                              Age:                           
PERSON TO NOTIFY IN CASE OF EMERGENCY:                                                                                        

SPONSORED BY:  (Memberís Name)                                                                           

Reason(s) for joining the Club:                                                                                                                       

Do you plan on attending meetings whenever possible?   Yes_____   No ____ 

Have you every applied or been a member before?         Yes_____   No ____  If so, when?                                     

Do you belong to any other sporting organizations?          Yes_____   No ____      
If yes, please List:  ____________________________________________________________________________  
Prior/current Military Service?  Yes ____  No ____   Branch _______________________ Dates: _________________

I have read and will abide by the bylaws and range rules of the club. Signed:_________________________________________________



1.       One (1) Time INITIATION FEE:                      $50.00*             *Must be submitted with the application. 

2.       ANNUAL DUES:                                            $75.00 or 100.00 This application most be presented in person, at a regular meeting.

       TOTAL FIRST YEAR MEMBERSHIP FEE:    $125 or $150.00 depending on age


Future Membership Fees:

Yearly Membership Fee (Age 61 and under)         $100.00   an annual maintenance fee may apply

Yearly Membership Fee (Age 62+ or disabled)      $75.00  

Spousal membership is 1/2 of member fee.


APPROVED:  Yes_____   No ____  (If NO (Disapproved), Note Date and Reason):  ____________________________________________     

PRESIDENT SIGNATURE:                                                                         

BOARD OF DIRECTORS:  (Where applicable):