Todd Jarrett Wins \\World Shoot X - uspsa

NROI RANGE OFFICER SEMINAR REQUESTClub or Section NameContact NameAddressCity & StateDaytime Phone numberWe would like to hold aPreferred dateOther datesSpecial Considerations:Please printZipE Level 1 r] Level 2 Range Officer Seminar.Alternate datePlease indicat,e which levelseminar you would like toschedule. You may scheduleboth levels if you like. Choose atleast two dates which are atleast three months from thetime you submit your request.Mail this form to USPSA Headquartersto the attention ofNROI at PO Box 811, SedroWoolley WA 98284, or fax it to(360) 855-0380. NROI will sendyou a confirmation of your requestwhen it is received. If youwould like a particular instructorto teach your seminar,please note it in the SpecialConsiderations section.NameAddressCity & StateUSPSA MEMBERSHIP APPLICATIONPlease pnntDaytime PhoneI am applying for the following type of membership. For renewals, notemembership number.E Annual (U.S.) $ 30.00 El Foreign Annual $ 40.00*D 3-Year (U.S. only) $ 75.00 E Foreign Life $ 600.00*0 5-year (U.S. only) $ 120.00 D Benefactor $ 1000.000 Life (U.S.) $ 500.00Note: Life and benefactor may be paid in four equal payments over a oneyeartime period. Credentials issued on completion of payment schedule.Visa Mastercard Exp. Dat,eCard #According to the legal requirements of the United States, are you able topurchase and possess firearms? yes noUSPSA/IPSCPO Box 811Sedro Woolley WA 98284Zip*Foreign rate applies to memberswith foreign addresses only.I hereby make application to jointhe USPSA under the plan andterms as noted above. I certifythat I will use the skills andknowledge gained inUSPSA/IPSC practical shootingonly in lawful sporting activitiesand self-defense, and that I willconduct myself in such a manneras not to bring the sport of practicalshooting into disrepute.(Please sign and enclose checkfor the appropriate amount.There will be a $15 servicecharge for all returned checks.)Date 19SignedUNITED STATESPRACTICAL SHOOTINGASSOCIATIONMarch/April 1997 Page 79