VERMONT FEDERATION OF SPORTSMEN'S CLUBS INC.

INDIVIDUAL or ASSOCIATE MEMBERSHIP APPLICATION

Name: ____________________________________

Street: _______________________________________________________

           _______________________________________________________

City:    _____________________  State: _________  Zip ______  -  _______

Phone: ______________________   eMail ____________________________

DUES CALCULATION:

Individual:  $15.00       Associate:  $75.00

Please return this form along with  a check payable to

Vermont Federation of Sportsmen's Clubs Inc.

PO Box 8523

Essex Jct., Vt. 05451-8523