St. Marys Sportsmen's Club 2012 Membership Application
Instructions: Please print-out a
copy of this application for each person applying,
complete the form legibly, and mail it with your payment(s) to:
PO Box 958
Saint Marys, PA 15857-0958
Membership type (check one):
o Senior $10.00 o Junior $2.00 (under 16)
Name: (please print) ______________________________________________________
City: __________________________________________ State: ______ Zip: ______________
If you would like to register for our Annual Coyote Hunt, please check the box(es) below and remit the registration fee of $8.00 (in addition to the membership dues, if not already a paid 2012 member).
$7.00 registration fee for prize money and $1.00 administration fee.
Mail-in registration must be received by February 11, 2012 and must include fee and a Self-Addressed Stamped Envelope.
o Yes, I would like to register for the 2012 Coyote Hunt and have read and understand the rules and regulations for the hunt.
o I have previously received my 2012 Membership. My 2012 Membership number is: _______________.
Coyote Hunt T-shirt Orders
Shirts are $10.00 each in Medium,
If the shirts are to be mailed, please add $3.00 shipping/handling charge for each shirt.
|Medium T-shirts at $10.00 each||= $___________|
|Large T-shirts at $10.00 each||= $___________|
|Extra-Large T-shirts at $10.00 each||= $___________|
Total for T-shirts