Name:__________________________________________________
Date:_______________
Alias:_______________________________________________________________________
Address:____________________________________________________________________
City:_____________________________________ State:________
Zip Code:_____________
Home Phone:_____________________________ Work/Cell
Phone:______________________
Email Address:________________________________________________________________
SASS #______________ NRA #___________________
RR Bar Member #____________
| FAMILY MEMBERS (SAME HOUSEHOLD) |
Spouse’s Name:______________________________________________________________
Alias:_______________________________________________________________________
SASS #_______________ NRA #___________________
RR Bar Member #___________
Work/Cell Phone:_________________________ Email:_______________________________
Child’s Name:___________________________________________DOB:_________________
Alias:_______________________________________________________________________
SASS #______________ NRA #____________________
RR Bar Member #___________
Tell us about any special skills you have or how
you may assist the club:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Return application with check payable to:
Double R Bar Regulators
P.O.Box 3105
Victorville, CA 92393-3105
www.rrbar.com |
For Internal Use:
Payment Method & Amount
________________________________
Badge(s) Ordered:
________________________________ |
Regular membership $25.00; Spouse
Membership $20.00; Child (under 17) $15.00 annually not to exceed $60.00
family. Membership badge $60.00 each. |
