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Membership Application<br />
SAFARI CLUB INTERNATIONAL<br />
NORTHWEST CHAPTER<br />
__________________________________________________________________________________<br />
NAME SPOUSE’S NAME<br />
___________________________________________________________________________________<br />
HOME ADDRESS<br />
CITY / STATE / ZIP COCE<br />
__________________________________________________________________________________<br />
BUSINESS ADDRESS / COMPANY NAME<br />
CITY / STATE / ZIP CODE<br />
_______________________________________<br />
HOME PHONE<br />
_____________________________________<br />
CELL PHONE<br />
_______________________________________<br />
DATE OF BIRTH<br />
______________________________________<br />
BUSINESS PHONE<br />
______________________________________<br />
FAX<br />
______________________________________<br />
EMAIL<br />
. Please check the address you prefer club notices be sent to: __ Home Address __ Business Address<br />
Name, as it should appear on SCI Name Badge ______________________________________________<br />
Vocation or Profession _________________________________________________________________<br />
We promote the freedom to hunt and wildlife conservation worldwide. We do this through quarterly<br />
newsletters, meeting with programs of interest, conservation and hunter education programs, public programs,<br />
family events, and an annual fund raising banquet. We are successful in these endeavors because we are an<br />
active club with active members. As a member of the Northwest Chapter, I am interested in helping in the<br />
following areas:<br />
Please check all that apply<br />
__ Chapter Meetings __ Membership __ Trophy Records & Awards<br />
__ Officer or Director __ Education __ Conservation Projects<br />
__ Youth Hunt __ Newsletter __ Sportsmen Against Hunger<br />
__ Fundraising __ Hunter’s Rights __ Publicity & Advertising<br />
To join our chapter, please: 1) fill out and sign this application, 2) obtain a club member’s sponsor, 3) mail a check<br />
for the first year’s dues payable to “Safari Club International” and mail to the membership chairman shown below.<br />
Safari Club offers Individual Memberships for $110 ($55 National + $55 Chapter) and Family Memberships for<br />
$130 ($75 National and $55 Chapter) which extends membership status to spouse and children under age 18.<br />
__ I am applying for Individual Membership: ($110 due with application)<br />
__ I am applying for Family Membership: ($130 due with application)<br />
__ I am applying for Chapter Membership: ($55 due, must also be a National member)<br />
__ I am applying for Chapter Life Membership: ($1000 due, must also be a National member)<br />
______________________________________________________________________________________________________________________<br />
SIGNED SPONSOR DATE<br />
Please mail your application and check to the Membership Chairman:<br />
SCI – NW Chapter, Gary Tennison, 9718 36 th Street NW, Gig Harbor, WA 98335-5893<br />
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